Frailty assessment in geriatric radiation oncology

Older adults with cancer are at risk of over-treatment or under-treatment, and treatment decision-making is difficult due to both the complexity of adverse aging and under-representation in clinical trials. It is recommended to perform a frailty assessment before treatment decision-making. Although the importance of radiotherapy increases in geriatric oncology, there is less evidence base information on frailty assessment in radiation oncology than in medical/surgical oncology. The present literature review analyzed the available data regarding frailty assessment tools in geriatric radiation oncology. The predictive value of geriatric assessment on survival outcomes has been shown in many cancer subtypes treated with radiotherapy. Additionally, the Geriatric-8 score is the most evidenced screening tool in frailty assessment. However, researches are ongoing on the cut-off points of geriatric screening tools and which one is the best. Prospective randomized controlled trials are required for the integration of geriatric screening tools and geriatric assessment-driven interventions into geriatric radiation oncology practice.