Prediction of hospital admissions and grade 3-4 toxicities in cancer patients 70 years old and older receiving chemotherapy.
Age Factors
Aged
Aged, 80 and over
Antineoplastic Agents
/ adverse effects
Antineoplastic Combined Chemotherapy Protocols
/ adverse effects
Chemotherapy, Adjuvant
/ adverse effects
Dose-Response Relationship, Drug
Female
Hospitalization
/ statistics & numerical data
Humans
Male
Multivariate Analysis
Neoplasms
/ drug therapy
Prognosis
cancer
chemotherapy
dose reduction
geriatric
hospital admissions
prediction
toxicity
Journal
European journal of cancer care
ISSN: 1365-2354
Titre abrégé: Eur J Cancer Care (Engl)
Pays: England
ID NLM: 9301979
Informations de publication
Date de publication:
Nov 2019
Nov 2019
Historique:
received:
08
10
2018
revised:
24
05
2019
accepted:
01
08
2019
pubmed:
21
8
2019
medline:
23
4
2020
entrez:
21
8
2019
Statut:
ppublish
Résumé
To predict chemotherapy toxicity and hospitalisations in elderly patients using clinical and laboratory parameters. Records of cancer patients 70 years old or older who received adjuvant chemotherapy or first-line chemotherapy for a cancer in a single centre were reviewed. Factors associated with hospitalisations, grade 3-4 toxicities and dose reductions during treatment were evaluated. A total of 275 patients included in the study. Most patients (53.8%) were 70 to 75 years old. One hundred and five patients (38.2%) had a hospital admission during or within a month after their chemotherapy treatment. The only factor associated with admissions in the multivariate analysis was ECOG performance status (PS) >1 (p = .008, odds ratio 2.66, 95% CI: 1.28-5.53) and hypoalbuminaemia approached significance. Grade 3 and 4 toxicities were associated with a lower creatinine clearance in the multivariate analysis (p = .01, odds ratio 0.98, 95% CI: 0.97-1.0), and dose reductions were associated with metastatic stage (p = .03, odds ratio 1.88, 95% CI: 1.05-3.35). A combined index with all four parameters was associated with all three outcomes of interest. ECOG PS, stage, albumin and creatinine clearance may be predictive of hospital admissions, grade 3-4 toxicities and dose reduction rates in cancer patients 70 years old and older receiving chemotherapy.
Substances chimiques
Antineoplastic Agents
0
Types de publication
Journal Article
Langues
eng
Pagination
e13144Subventions
Organisme : Sault Ste Marie Academic Medical Association
ID : NA
Informations de copyright
© 2019 John Wiley & Sons Ltd.
Références
Extermann, M., Boler, I., Reich, R. R., Lyman, G. H., Brown, R. H., DeFelice, J., … Balducci, L. (2012). Predicting the risk of chemotherapy toxicity in older patients: The chemotherapy risk assessment scale for high-age patients (CRASH) score. Cancer, 118, 3377-3386. https://doi.org/10.1002/cncr.26646
Extermann, M., Bonetti, M., Sledge, G. W., O'Dwyer, P. J., Bonomi, P., & Benson, A. B. III (2004). MAX2- a convenient index to estimate the average per patient risk for chemotherapy toxicity: Validation in ECOG trials. European Journal of Cancer, 40, 1193-1198. https://doi.org/10.1016/j.ejca.2004.01.028
Falandry, C., Brain, E., Bonnefoy, M., Mefti, F., Jovenin, N., Rigal, O., & Freyer, G., (2013). Impact of geriatric risk factors on pegylated liposomal doxorubicin tolerance and efficacy in elderly metastatic breast cancer patients; final results of the DOGMES multicenter GINECO trial. European Journal of Cancer, 49, 2806-2814.
Freyer, G., Geay, J.-F., Touzet, S., Provencal, J., Weber, B., Jacquin, J.-P., … Pujade-Lauraine, E. (2005). Comprehensive geriatric assessment predicts tolerance to chemotherapy and survival in elderly patients with advanced ovarian carcinoma: A GINECO study. Annals of Oncology, 16, 1795-1800. https://doi.org/10.1093/annonc/mdi368
Gironés, R., Torregrosa, D., Gómez-Codina, J., Maestu, I., Tenias, J. M., & Rosell, R. (2012). Lung cancer chemotherapy decisions in older patients: The role of patient preference and interactions with physicians. Clinical and Translational Oncology, 14, 183-189. https://doi.org/10.1007/s12094-012-0782-6
Hurria, A., Mohile, S., Gajra, A., Klepin, H., Muss, H., Chapman, A., … Tew, W. P. (2016). Validation of a prediction tool for chemotherapy toxicity in older adults with cancer. Journal of Clinical Oncology, 34, 2366-2371. https://doi.org/10.1200/JCO.2015.65.4327
Hurria, A., Togawa, K., Mohile, S. G., Owusu, C., Klepin, H. D., Gross, C. P., … Tew, W. P. (2011). Predicting chemotherapy toxicity in older adults with cancer: A prospective multicenter study. Journal of Clinical Oncology, 29, 3457-3465. https://doi.org/10.1200/JCO.2011.34.7625
Janssen-Heijnen, M. L. G., Maas, H. A. A. M., Koning, C. C. E., van der Bruggen-Bogaarts, B. A. H. A., Groen, H. J. M., & Wymenga, A. N. M. (2014). Tolerance and benefits of treatment for elderly patients with limited small-cell lung cancer. Journal of Geriatric Oncology, 5, 71-77. https://doi.org/10.1016/j.jgo.2013.07.008
Korc-Grodzicki, B., Holmes, H. M., & Shahrokni, A. (2015). Geriatric assessment for oncologists. Cancer Biology & Medicine, 12, 261-274.
Lee, J.-C., Kim, J. W., Ahn, S., Kim, H. W., Lee, J., Kim, Y. H., … Hwang, J.-H. (2017). Optimal dose reduction of FOLFIRINOX for preserving tumour response in advanced pancreatic cancer: Using cumulative relative dose intensity. European Journal of Cancer, 76, 125-133. https://doi.org/10.1016/j.ejca.2017.02.010
Miller, K. D., Siegel, R. L., Lin, C. C., Mariotto, A. B., Kramer, J. L., Rowland, J. H., … Jemal, A. (2016). Cancer treatment and survivorship statistics, 2016. CA Cancer Journal for Clinicians, 66, 271-289. https://doi.org/10.3322/caac.21349
Mohile, S. G., Dale, W., Somerfield, M. R., Schonberg, M. A., Boyd, C. M., Burhenn, P. S., … Hurria, A. (2018). Practical assessment and management of vulnerabilities in older patients receiving chemotherapy: ASCO guideline for geriatric oncology. Journal of Clinical Oncology, 36, 2326-2347. https://doi.org/10.1200/JCO.2018.78.8687
Moth, E. B., Kiely, B. E., Stefanic, N., Naganathan, V., Martin, A., Grimison, P., … Blinman, P. (2019). Predicting chemotherapy toxicity in older adults: Comparing the predictive value of the CARG Toxicity Score with oncologists' estimates of toxicity based on clinical judgement. Journal of Geriatric Oncology, 10, 202-209. https://doi.org/10.1016/j.jgo.2018.08.010
Nishijima, T. F., Deal, A. M., Williams, G. R., Sanoff, H. K., Nyrop, K. A., & Muss, H. B. (2018). Chemotherapy toxicity risk score for treatment decisions in older adults with advanced solid tumors. The Oncologist, 23, 573-579. https://doi.org/10.1634/theoncologist.2017-0559
Ramsden, K., Laskin, J., & Ho, C. (2015). Adjuvant chemotherapy in resected stage II Non-small cell lung cancer: Evaluating the impact of dose intensity and time to treatment. Clinical Oncology, 27, 394-400. https://doi.org/10.1016/j.clon.2015.03.001
Van Leeuwen, B. L., Rosenkranz, K. M., Lei Feng, L., Bedrosian, I., Hartmann, K., Hunt, K. K., … Babiera, G. V. (2011). The effect of under-treatment of breast cancer in women 80 years of age and older. Critical Reviews in Oncology and Hematology, 79, 315-320. https://doi.org/10.1016/j.critrevonc.2010.05.010
Voutsadakis, I. A. (2018). Clinical tools for chemotherapy toxicity prediction and survival in geriatric cancer patients. Journal of Chemotherapy, 30, 266-279. https://doi.org/10.1080/1120009X.2018.1475442
Wildiers, H., Heeren, P., Puts, M., Topinkova, E., Janssen-Heijnen, M. L. G., Extermann, M., … Hurria, A. (2014). International society of geriatric oncology consensus on geriatric assessment in older patients with cancer. Journal of Clinical Oncology, 32, 2595-2603. https://doi.org/10.1200/JCO.2013.54.8347
Wong, M. L., McMurry, T. L., Stukenborg, G. J., Francescatti, A. B., Amato-Martz, C., Schumacher, J. R., … Kozower, B. D. (2016). Impact of age and comorbidity on treatment of non-small cell lung cancer recurrence following complete resection: A nationally representative cohort study. Lung Cancer, 102, 108-117. https://doi.org/10.1016/j.lungcan.2016.11.002