Geriatric assessment may help decision-making in elderly patients with inoperable, locally advanced non-small-cell lung cancer.

Autor: Antonio M; Thoracic Oncology Unit, Department of Medical Oncology, Institut Català d'Oncologia, Hospital Duran i Reynals, Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain.; Geriatric Oncology Unit, Department of Medical Oncology, Institut Català d'Oncologia, Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain., Saldaña J; Thoracic Oncology Unit, Department of Medical Oncology, Institut Català d'Oncologia, Hospital Duran i Reynals, Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain.; Geriatric Oncology Unit, Department of Medical Oncology, Institut Català d'Oncologia, Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain., Linares J; Thoracic Oncology Unit, Department of Medical Oncology, Institut Català d'Oncologia, Hospital Duran i Reynals, Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain., Ruffinelli JC; Thoracic Oncology Unit, Department of Medical Oncology, Institut Català d'Oncologia, Hospital Duran i Reynals, Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain., Palmero R; Thoracic Oncology Unit, Department of Medical Oncology, Institut Català d'Oncologia, Hospital Duran i Reynals, Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain., Navarro A; Thoracic Oncology Unit, Department of Radiation Oncology, Institut Català d'Oncologia. Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain., Arnaiz MD; Thoracic Oncology Unit, Department of Radiation Oncology, Institut Català d'Oncologia. Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain., Brao I; Thoracic Oncology Unit, Department of Medical Oncology, Institut Català d'Oncologia, Hospital Duran i Reynals, Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain., Aso S; Department of Respiratory Medicine, Hospital Universitari de Bellvitge, Feixa Llarga, s/n, 08907. L'Hospitalet, Barcelona 08907, Spain., Padrones S; Department of Respiratory Medicine, Hospital Universitari de Bellvitge, Feixa Llarga, s/n, 08907. L'Hospitalet, Barcelona 08907, Spain., Navarro V; Clinical Research Unit, Institut Català d'Oncologia, Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain., González-Barboteo J; Palliative Care Unit, Institut Català d'Oncologia, Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain., Borràs JM; Department of Clinical Sciences, IDIBELL, University of Barcelona, Feixa Llarga, s/n, 08908. L'Hospitalet, Barcelona 08907, Spain., Cardenal F; Thoracic Oncology Unit, Department of Medical Oncology, Institut Català d'Oncologia, Hospital Duran i Reynals, Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain., Nadal E; Thoracic Oncology Unit, Department of Medical Oncology, Institut Català d'Oncologia, Hospital Duran i Reynals, Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain.; Clinical Research in Solid Tumors (CReST) Group, OncoBell Program, IDIBELL, Avinguda Gran via 199-203. L'Hospitalet, Barcelona 08908, Spain.
Jazyk: angličtina
Zdroj: British journal of cancer [Br J Cancer] 2018 Mar 06; Vol. 118 (5), pp. 639-647. Date of Electronic Publication: 2018 Jan 30.
DOI: 10.1038/bjc.2017.455
Abstrakt: Background: Although concurrent chemoradiotherapy (cCRT) increases survival in patients with inoperable, locally advanced non-small-cell lung cancer (NSCLC), there is no consensus on the treatment of elderly patients. The aim of this study was to determine the prognostic value of the comprehensive geriatric assessment (CGA) and its ability to predict toxicity in this setting.
Methods: We enrolled 85 consecutive elderly (⩾75 years) participants, who underwent CGA and the Vulnerable Elders Survey (VES-13). Those classified as fit and medium-fit by CGA were deemed candidates for cCRT (platinum-based chemotherapy concurrent with thoracic radiation therapy), while unfit patients received best supportive care.
Results: Fit (37%) and medium-fit (48%) patients had significantly longer median overall survival (mOS) (23.9 and 16.9 months, respectively) than unfit patients (15%) (9.3 months, log-rank P=0.01). In multivariate analysis, CGA groups and VES-13 were independent prognostic factors. Fit and medium-fit patients receiving cCRT (n=54) had mOS of 21.1 months (95% confidence interval: 16.2, 26.0). In those patients, higher VES-13 (⩾3) was associated with shorter mOS (16.33 vs 24.3 months, P=0.027) and higher risk of G3-4 toxicity (65 vs 32%, P=0.028).
Conclusions: Comprehensive geriatric assessment and VES-13 showed independent prognostic value. Comprehensive geriatric assessment may help to identify elderly patients fit enough to be treated with cCRT.
Databáze: MEDLINE
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