E. Actuellement, . Europe, and . Etas-unis, plus de 60% des cancers sont diagnostiqués chez des patients de plus de 65 ans Cette population est hétérogène, souvent fragile et à risque de complications, Ce pourcentage pourrait augeetee jussuà % daas les tteete aaes à venir

L. Et-nutritionnelles-qui-entourent-la-personne-Âgée-nécessitent-un-traitement-oncologique-personnel, Plusieurs syndromes gériatriques sont importants à rechercher et à prendre en charge avant tout traitement de la maladie néoplasique. La première notion à connaitre est la iatrogénie car les interactions médicamenteuses augmentent avec le nombre de traitements concomitants (5) Or aux Etats-Unis, plus de 80% des patients cancéreux de plus de 65 ans souffrent de co-morbidités pour lesquelles un traitement est nécessaire (6) Dautte paat la populatio âge dans son ensemble est à risque de malnutrition, voire de dénutrition. Pour Guigoz et al. une malnutrition est retrouvée chez 1 à 5 % des patients âgés vivant à domicile. Cette prévalence est de 20% dans la population hospitalisée et jussuà 37% dans la population vivant en institution (7) Ltat ogitif est tout aussi pioodial daas ette [1,3, 2006.

. Bibliographie-1, R. Yancik, L. Ries, R. Siegel, D. Naishadham et al., The potential for drug interactions Identifying the elderly at risk for malnutrition The Mini Nutritional Assessment General guidelines for the management of older patients with cancer EORTC elderly task force position paper: approach to the older cancer patient Management of cancer in the older person: a practical approach National Institutes of Health Consensus Development Conference Statement: geriatric assessment methods for clinical decision-making Comprehensive geriatric assessment: a meta-analysis of controlled trials Comprehensive geriatric assessment and its clinical impact in oncology A controlled trial of inpatient and outpatient geriatric evaluation and management Care of breast cancer in the elderly woman--what does comprehensive geriatric assessment (CGA) help? Support Care Cancer Comprehensive geriatric assessment predicts tolerance to chemotherapy and survival in elderly patients with advanced ovarian carcinoma: a GINECO study Pretreatment quality of life and functional status assessment significantly predict survival of elderly patients with advanced non-small-cell lung cancer receiving chemotherapy: a prognostic analysis of the multicenter Italian lung cancer in the elderly study Comprehensive assessment of the elderly cancer patient: the feasibility of self-report methodology Higher vulnerable elders survey scores predict death and functional decline in vulnerable older people The Vulnerable Elders Survey: a tool for identifying vulnerable older people in the community Detecting disabilities in older patients with cancer: comparison between comprehensive geriatric assessment and vulnerable elders survey-13 Screening older cancer patients: first evaluation of the G-8 geriatric screening tool Frailty screening methods for predicting outcome of a comprehensive geriatric assessment in elderly patients with cancer: a systematic review The clinical evaluation of chemotherapeutic agents in cancer Evaluation of patients with advanced cancer using the Karnofsky performance status Karnofsky and ECOG performance status scoring in lung cancer: a prospective, longitudinal study of 536 patients from a single institution Palliative chemotherapy in elderly patients with common metastatic malignancies: A Hellenic Cooperative Oncology Group registry analysis of management, outcome and clinical benefit predictors Predicting the risk of chemotherapy toxicity in older patients: the Chemotherapy Risk Assessment Scale for High-Age Patients (CRASH) score. Cancer. 1 juill 2012 Assessing self-maintenance: activities of daily living, mobility, and instrumental activities of daily living Assessment of older people: self-maintaining and instrumental activities of daily living. The Gerontologist Comprehensive geriatric assessment adds information to Eastern Cooperative Oncology Group performance status in elderly cancer patients: an Italian Group for Geriatric Oncology Study Comorbidity and functional status are independent in older cancer patients Development and validation of a prognostic index for 1-year mortality in older adults after hospitalization Predictors of immediate and 6-month outcomes in hospitalized elderly patients. The importance of functional status Importance of functional measures in predicting mortality among older hospitalized patients Comprehensive geriatric assessment in a day hospital The impact of cancer on the physical function of the elderly and their utilization of health care. Cancer. 15 nov Physical and mental health status of older long-term cancer survivors Validation of a multidimensional evaluation scale for use in elderly cancer patients. Cancer. 15 janv Age, severe comorbidity and functional impairment independently contribute to poor survival in cancer patients Predictors of early death risk in older patients treated with first-line chemotherapy for cancer The timed « Up & Go »: a test of basic functional mobility for frail elderly persons142?148, 49, Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients Implications of mobility impairment on the diagnosis and treatment of breast cancer TTeateet fo east aaee i patieets ith Alzheieees disease Patterns of presentation, diagnosis, and treatment in older patients with colon cancer and comorbid dementia « Mini-mental state ». A practical method for grading the cognitive state of patients for the clinician Clock completion: an objective screening test for dementia Patterns of presentation, diagnosis, and treatment in older patients with colon cancer and comorbid dementia Predictive value of geriatric assessment for patients older than 70 years, treated with chemotherapy Effect of adjuvant breast aaee heeotheap o ogitie futio ffo the oldee patieetts peespeetie Can older cancer patients tolerate chemotherapy? A prospective pilot study A comprehensive geriatric intervention detects multiple problems in older breast cancer patients Preoperative assessment of surgical risk in oncogeriatric patients. The oncologist Effect of depression on diagnosis, treatment, and survival of older women with breast cancer Social networks, social support, and survival after breast cancer diagnosis Assessing the nutritional status of the elderly: The Mini Nutritional Assessment as part of the geriatric evaluation Baseline nutritional assessment in advanced cancer patients receiving palliative chemotherapy Weight change in old age and its association with mortality Weight, weight change, mortality in a random sample of older community-dwelling women Body mass index and mortality among older people living in the community An epidemiological evaluation of the prevalence of malnutrition in Spanish patients with locally advanced or metastatic cancer The cancer cachexia syndrome: a review of metabolic and clinical manifestations Evaluation of nutritional and inflammatory status of advanced colorectal cancer patients and its correlation with survival Predictive value of geriatric assessment for patients older than 70 years, treated with chemotherapy Prognostic effect of weight loss prior to chemotherapy in cancer patients. Eastern Cooperative Oncology Group Evaluation of the nutritional and inflammatory status in cancer patients for the risk assessment of severe haematological toxicity following chemotherapy Association of nutritional status and serum albumin levels with development of toxicity in patients with advanced non-small cell lung cancer treated with paclitaxel-cisplatin chemotherapy: a prospective study Sarcopenia as a determinant of chemotherapy toxicity and time to tumor progression in metastatic breast cancer patients receiving capecitabine treatment Impact of liposomal doxorubicin-based adjuvant chemotherapy on autonomy in women over 70 with hormonereceptor-negative breast carcinoma: A French Geriatric Oncology Group (GERICO) phase II multicentre trial Polypharmacy in older oncology patients and the need for an interdisciplinary approach to side-effect management, disability and geriatric syndromes in elderly breast cancer survivors. Results of a single-center experience Geriatric Index of Comorbidity: validation and comparison with other measures of comorbidity Prognostic importance of comorbidity in a hospital-based cancer registry Comparison of Scoring Methods for ACE- 27: Simpler Is Better Rating chronic medical illness burden in geropsychiatric practice and research: application of the Cumulative Illness Rating Scale Validation of a combined comorbidity index A new method of classifying prognostic comorbidity in longitudinal studies: development and validation Gemcitabine plus vinorelbine versus vinorelbine alone in elderly patients with advanced non-small-cell lung cancer Greater influence of age than co-morbidity on primary treatment and complications of prostate cancer patients: an in-depth population-based study Effects of aging on the renal glomerulus Renal insufficiency in elderly cancer patients: International Society of Geriatric Oncology clinical practice recommendations Enrollment of elderly patients in clinical trials for cancer drug registration: a 7-year experience by the US Food and Drug Administration Enrollment of older patients in cancer treatment trials in Canada: why is age a barrier Cetuximab and gemcitabine in elderly or adult PS2 patients with advanced non-small-cell lung cancer: The cetuximab in advanced lung cancer (CALC1-E and CALC1-PS2) randomized phase II trials Evaluation of adverse events experienced by older patients participating in studies of molecularly targeted agents alone or in combination A randomized phase II trial of pemetrexed/gemcitabine/bevacizumab or pemetrexed/carboplatin/bevacizumab in the first-line treatment of elderly patients with advanced non-small cell lung cancer Efficacy and safety of bevacizumab-based therapy in elderly patients with advanced or recurrent nonsquamous nonsmall cell lung cancer in the phase III BO17704 study (AVAiL) Safety and efficacy of first-line bevacizumab plus chemotherapy in elderly patients with advanced or recurrent nonsquamous non-small cell lung cancer: safety of avastin in lung trial (MO19390) al. Outcomes for elderly, advanced-stage non small-cell lung cancer patients treated with bevacizumab in combination with carboplatin and paclitaxel: analysis of Eastern Cooperative Oncology Group Trial 4599 al. Efficacy and safety of bevacizumab in combination with docetaxel for the first-line treatment of elderly patients with locally recurrent or metastatic breast cancer: results from AVADO Arterial thromboembolic events in patients with metastatic carcinoma treated with chemotherapy and bevacizumab Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer XELOX (capecitabine plus oxaliplatin): active first-line therapy for patients with metastatic colorectal cancer Randomized phase III study of capecitabine plus oxaliplatin compared with fluorouracil/folinic acid plus oxaliplatin as first-line therapy for metastatic colorectal cancer al. XELOX vs FOLFOX-4 as first-line therapy for metastatic colorectal cancer: NO16966 updated results al. irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomised trial A phase I/II and pharmacokinetic study of irinotecan in combination with capecitabine as first-line therapy for advanced colorectal cancer bolus, or oral fluoropyrimidines in first-line treatment of metastatic colorectal cancer: results from the BICC-C Study The oncologist KRAS mutations as an independent prognostic factor in patients with advanced colorectal cancer treated with cetuximab Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer Efficacy of 5- fluorouracil-based chemotherapy in elderly patients with metastatic colorectal cancer: a pooled analysis of clinical trials Capecitabine as first-line treatment for patients older than 70 years with metastatic colorectal cancer: an oncopaz cooperative group study Oxaliplatin-or irinotecanbased chemotherapy for metastatic colorectal cancer in the elderly, Cancer in older persons: an international issue in an aging world Disponible sur Cancer statistics America. Demographic and epidemiologic perspectives Disponible sur Europe: estimates for 40 countries in 2012 al. Phase III trial of infusional fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) compared with infusional fluorouracil, leucovorin, and irinotecan (FOLFIRI) as first-line treatment for metastatic colorectal cancer: the Gruppo Oncologico Nord Ovest al. FOLFOXIRI (folinic acid, 5-fluorouracil, oxaliplatin and irinotecan) vs FOLFIRI (folinic acid, 5-fluorouracil and irinotecan) as first-line treatment in metastatic colorectal cancer (MCC): a multicentre randomised phase III trial from the Hellenic Oncology Research Group (HORG) al. Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer M, DiBartolomeo M, et al. Safety and efficacy of first-line bevacizumab with FOLFOX, XELOX, FOLFIRI and fluoropyrimidines in metastatic colorectal cancer: the BEAT study DM, et al. Clinical outcomes associated with bevacizumab-containing treatment of metastatic colorectal cancer: the BRiTE observational cohort study al. Fluorouracil, leucovorin, and oxaliplatin with and without cetuximab in the first-line treatment of metastatic colorectal cancer of the folinic acid/5-fluorouracil/irinotecan (FOLFIRI 1) regimen in elderly patients as a first-line treatment for metastatic colorectal cancer: a Phase II study first-line therapy of older and younger patients with metastatic colorectal cancer: combined analysis of 2,691 patients in randomized controlled trials, pp.507-511, 1965.

A. Figer, N. Perez-staub, C. E. Tournigand, C. Lledo, G. Flesch et al., Pooled analysis of safety and efficacy of oxaliplatin plus fluorouracil/leucovorin administered bimonthly in elderly patients with colorectal cancer XELOX (capecitabine plus oxaliplatin) as first-line treatment for elderly patients over 70 years of age with advanced colorectal cancer Capecitabine plus oxaliplatin for the first-line treatment of elderly patients with metastatic colorectal carcinoma: final results of the Southern Italy Cooperative Oncology Group Trial 0108, Cancer. 15 juill Comparing safety and efficacy of first-line irinotecan/fluoropyrimidine combinations in elderly versus nonelderly patients with metastatic colorectal cancer: findings from the bolus, infusional, or capecitabine with camptostar-celecoxib study. Cancer. 15 juin Effect of bevacizumab in older patients with metastatic colorectal cancer: pooled analysis of four randomized studies Bevacizumab plus capecitabine versus capecitabine alone in elderly patients with previously untreated metastatic colorectal cancer (AVEX): an open-label, randomised phase 3 trial Clinical outcomes in elderly patients with metastatic colorectal cancer receiving bevacizumab and chemotherapy: results from the BRiTE observational cohort study Cetuximab-based therapy in elderly comorbid patients with metastatic colorectal cancer al. First-line cetuximab plus capecitabine in elderly patients with advanced colorectal cancer: clinical outcome and subgroup analysis according to KRAS status from a Spanish TTD Group Study. The oncologist Utilization of bevacizumab in US elderly patients with colorectal cancer receiving chemotherapy, FOLFOX in patients aged between 76 and 80 years with metastatic colorectal cancer: an exploratory cohort of the OPTIMOX1 study. Cancer. 15 déc M, et al. Panitumumab-FOLFOX4 treatment and RAS mutations in colorectal cancer, pp.282-289737, 2005.

T. Aparicio, J. Jouve, L. Teillet, D. Gargot, F. Subtil et al., for metastatic colorectal cancer in elderly patients Functional decline in older patients with cancer receiving first-line chemotherapy Performance of two geriatric screening tools in older patients with cancer Bevacizumab use and risk of cardiovascular adverse events among elderly patients with colorectal cancer receiving chemotherapy: a population-based study Chemotherapy options in elderly and frail patients with metastatic colorectal cancer (MRC FOCUS2): an open-label, randomised factorial trial Pooled safety and efficacy analysis examining the effect of performance status on outcomes in nine first-line treatment trials using individual data from patients with metastatic colorectal cancer Addition of aflibercept to fluorouracil, leucovorin, and irinotecan improves survival in a phase III randomized trial in patients with metastatic colorectal cancer previously treated with an oxaliplatin-based regimen, Geriatric factors predict chemotherapy feasibility: ancillary results of FFCD 2001-02 phase III study in first-line chemotherapy al. Continuation of bevacizumab after first progression in metastatic colorectal cancer (ML18147): a randomised phase 3 trial al. End points and trial design in geriatric oncology research: a joint European organisation for research and treatment of cancer-- Alliance for Clinical Trials in Oncology--International Society Of Geriatric Oncology position article, pp.19-263499, 2009.

C. Kenis, D. Bron, Y. Libert, L. Decoster, K. Van-puyvelde et al., Relevance of a systematic geriatric screening and assessment in older patients with cancer: results of a prospective multicentric study Factors influencing general practitioners in the referral of elderly cancer patients, J Clin Oncol Ann Oncol. mai BMC Cancer, vol.312411, issue.1455, 2011.