Geriatric Assessment and Management for Older Adults Undergoing Radiation Therapy for Head and Neck Cancer and Their Family Caregivers
City of Hope Medical Center
Summary
This clinical trial compares the effect of geriatric assessment (GA)-based management of supportive care to usual care in treating older patients undergoing chemotherapy and radiation therapy for head and neck cancer and their family caregivers (FCG). At least one quarter of head and neck cancers patients are diagnosed at age 70 or older. Treatment for head and neck cancers usually include surgery, chemotherapy, and radiation. Older adults are often at higher risk for functional problems, and may experience more side effects. In addition, there may be a lack of support mechanisms in place to address the needs of these older patients. Cancer not only affects the patients but the entire family, especially the family member who is the caregiver. Currently, all patients over 65 receive the same standard of care based on national guidelines, which include supportive care referrals. However, data suggests, that many patients may need more frequent and structured support. The Practical Geriatric Assessment (PGA) is a complete examination including evaluation of the physical and mental function as well as the emotional state of the older patient. PGA-based supportive care interventions may be safe, tolerable, and/or effective in managing treatment-related side effects and improving quality of life compared to usual care in older patients undergoing chemotherapy and radiation therapy for head and neck cancer and their FCG.
Description
PRIMARY OBJECTIVE: I. To evaluate the safety of the intervention by evaluation of treatment-related toxicities. SECONDARY OBJECTIVES: I. To assess the feasibility, retention, and acceptability of the intervention. II. To assess the rate of any grade non-hematologic treatment-related toxicities. III. To assess patient/FCG self-reported outcomes. IV. To assess the symptom-related outcomes by evaluation of unplanned readmissions and emergency room (ER)/urgent care visits. OUTLINE: Patients are randomized to 1 of 2 arms. Caregivers are randomized to the same arm as the corresponding patients.…
Eligibility
- Age range
- 18+ years
- Sex
- All
- Healthy volunteers
- Yes
Inclusion Criteria: * PATIENT: Documented written informed consent of the participant * PATIENT: Diagnosis of non-metastatic head and neck cancer * PATIENT: Age: ≥ 60 years * PATIENT: Patient must be scheduled to undergo curative-intent, definitive radiation with or without concurrent chemotherapy or postoperative radiation with or without concurrent chemotherapy * PATIENT: Patients must have at least one geriatric assessment as assessed by the modified Geriatric 8 (G8) tool * PATIENT: Family caregivers (FCGs) are highly encouraged to participate but this is not required. Patients without FCG…
Interventions
- OtherBest Practice
Receive usual care
- OtherElectronic Health Record Review
Ancillary studies
- BehavioralHealth Communication
Shared with treating oncology
- OtherInterview
Ancillary studies
- OtherOffice Visit
Attend regular clinical visits
- OtherPractical Geriatric Assessment
Undergo PGA
- OtherQuestionnaire Administration
Ancillary studies
Location
- City of Hope Medical CenterDuarte, California