Journal of geriatric oncology · 2026
Effect of comprehensive geriatric assessment and supportive care on quality of life in older patients with cancer receiving curative treatment: The GOSPEL randomised controlled trial.
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Goh Wen Yang, Ho Francis C H, Neo Han Yee, Koh Mervyn Y H, Lim Ming Yann, Teo Hui Lin, Hum Allyn Y M
Аннотация
INTRODUCTION: Older adults receiving curative-intent cancer treatment face a challenging balance between treatment and quality-of-life (QoL). While comprehensive geriatric assessment (CGA) is known to reduce toxicity, its impact on QoL remains inconsistent. Early supportive care has been shown to improve QoL. The Geriatric Oncology SuPportive clinic for ELderly (GOSPEL) study aimed to determine if a geriatric oncology supportive clinic (GOSC) can maintain QoL in older adults undergoing curative-intent chemotherapy and/or radiotherapy.
MATERIALS AND METHODS: This single-center, randomised controlled trial enrolled patients aged ≥65 years with a Geriatric-8 (G8) score ≤ 14 and solid organ malignancies scheduled for curative treatment. Participants were randomised 1:1 to GOSC (CGA-guided multidisciplinary interventions and supportive care) or usual care. The primary outcome was the change in QoL (EORTC QLQ-ELD14 mobility subscale). Secondary outcomes included EQ-5D-VAS, treatment toxicity, healthcare utilisation, and survival.
RESULTS: Fifty-two participants (mean age 71.8 years; mean G8 12.1) were randomised 1:1 to both arms between 2019 and 2024. While there was no significant difference in the primary outcome between the arms, the intervention arm demonstrated significant longitudinal improvement in the secondary analysis of quality-of-life mean EQ-5D-VAS at 1, 2, 3, 6, and 12 months compared to baseline (all p < 0.05). No significant differences were found between the GOSC and UC arms regarding treatment-related toxicity, healthcare utilisation, or overall and disease-free survival.
DISCUSSION: GOSPEL showed that addition of supportive care measures along with CGA-guided multidisciplinary intervention (GOSC) improves quality of life in older adults undergoing curative treatment for solid organ cancer. Larger multicenter studies are needed to confirm these benefits.
MATERIALS AND METHODS: This single-center, randomised controlled trial enrolled patients aged ≥65 years with a Geriatric-8 (G8) score ≤ 14 and solid organ malignancies scheduled for curative treatment. Participants were randomised 1:1 to GOSC (CGA-guided multidisciplinary interventions and supportive care) or usual care. The primary outcome was the change in QoL (EORTC QLQ-ELD14 mobility subscale). Secondary outcomes included EQ-5D-VAS, treatment toxicity, healthcare utilisation, and survival.
RESULTS: Fifty-two participants (mean age 71.8 years; mean G8 12.1) were randomised 1:1 to both arms between 2019 and 2024. While there was no significant difference in the primary outcome between the arms, the intervention arm demonstrated significant longitudinal improvement in the secondary analysis of quality-of-life mean EQ-5D-VAS at 1, 2, 3, 6, and 12 months compared to baseline (all p < 0.05). No significant differences were found between the GOSC and UC arms regarding treatment-related toxicity, healthcare utilisation, or overall and disease-free survival.
DISCUSSION: GOSPEL showed that addition of supportive care measures along with CGA-guided multidisciplinary intervention (GOSC) improves quality of life in older adults undergoing curative treatment for solid organ cancer. Larger multicenter studies are needed to confirm these benefits.