Patient- and tumor-related predictors of chemotherapy intolerance in older patients with cancer: A systematic review.

Autor: van Abbema DL; Department of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands; ACHIEVE Centre for Applied Research, Faculty of Health, Amsterdam University of Applied Sciences, Amsterdam, Netherlands. Electronic address: d.l.van.abbema@hva.nl., van den Akker M; Department of Family Medicine, Maastricht University, Maastricht, The Netherlands; Department of General Practice, KU Leuven, Leuven, Belgium., Janssen-Heijnen ML; Department of Clinical Epidemiology, Viecuri Medical Centre, Venlo, the Netherlands; Department of Epidemiology, Maastricht University Medical Centre, GROW School for Oncology and Developmental Biology, Maastricht, The Netherlands., van den Berkmortel F; Department of Internal Medicine, Zuyderland Medical Center, Heerlen-Geleen, The Netherlands., Hoeben A; Department of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands., de Vos-Geelen J; Department of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands., Buntinx F; Department of Family Medicine, Maastricht University, Maastricht, The Netherlands; Department of General Practice, KU Leuven, Leuven, Belgium., Kleijnen J; Department of Family Medicine, Maastricht University, Maastricht, The Netherlands., Tjan-Heijnen VCG; Department of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands. Electronic address: vcg.tjan.heijnen@mumc.nl.
Jazyk: angličtina
Zdroj: Journal of geriatric oncology [J Geriatr Oncol] 2019 Jan; Vol. 10 (1), pp. 31-41. Date of Electronic Publication: 2018 Apr 26.
DOI: 10.1016/j.jgo.2018.04.001
Abstrakt: Objective: The aim of this systematic review was to investigate patient-related factors (e.g. depressive symptoms, cognition, mobility, activities of daily living (ADL)) as well as tumor-related factors (e.g. tumor type, chemotherapy regimen) influencing chemotherapy intolerance in cancer patients aged 65 years or older.
Methods: We included observational studies that reported data on possible predictors of chemotherapy intolerance in older patients with cancer. We studied chemotherapy intolerance using the following outcomes: chemotherapy toxicity grade 3 to 5, unplanned hospitalization, chemotherapy discontinuation, chemotherapy dose reduction, functional decline, and chemotherapy mortality. We searched PubMed, Embase, and PsycInfo for articles between January 1995 and July 2016. The quality of the included studies was assessed using the Quality in Prognosis Studies (QUIPS) tool.
Results: The search yielded 1774 articles, and 30 articles from 27 studies were included. The patient-related factors associated with chemotherapy intolerance, in terms of the size of the association and the consistency of the results, were more than one fall in the last six months, mobility problems, poor performance status and the presence of severe comorbid conditions. The tumor-related factors that were associated with chemotherapy intolerance in older patients with cancer were certain regimens of chemotherapy and polychemotherapy, as compared to monochemotherapy. The number of studies on unplanned hospitalization and functional decline was small.
Conclusion: The included studies were heterogeneous with respect to endpoints and included parameters. Nevertheless, the size of the association and the consistency of results suggest that all these factors are relevant for everyday oncological practice.
(Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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