Association Between Geriatric Assessment and Post-Chemotherapy Functional Status in Older Patients with Cancer.

Autor:	Rier HN; Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands.; Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands., Meinardi MC; Department of Geriatric Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands., van Rosmalen J; Department of Biostatistics, Erasmus MC, Rotterdam, The Netherlands.; Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands., Westerweel PE; Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands., de Jongh E; Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands., Kitzen JJEM; Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands., van den Bosch J; Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands., Trajkovic M; Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands., Levin MD; Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
Jazyk:	angličtina
Zdroj:	The oncologist [Oncologist] 2022 Nov 03; Vol. 27 (11), pp. e878-e888.
DOI:	10.1093/oncolo/oyac131
Abstrakt:	Background: Maintaining functional status is among the most important patient-centered outcomes for older adults with cancer. This study investigated the association between comprehensive geriatric assessment (CGA) and progressive disease or decline of IADL-independence 1 year after chemotherapy, overall survival (OS), and premature termination of chemotherapy. CGA-based functional status and quality of life (QOL) 1 year after chemotherapy are also described. Methods: This prospective cohort study involved patients aged ≥65 years treated with chemotherapy for any cancer type. CGA and the G8-screening tool were performed before and after the completion of chemotherapy. Analyses were adjusted for tumor type and treatment intent: (a) indolent hematological malignancies, (b) aggressive hematological malignancies, c) solid malignancies treated with curative intent, and (d) solid malignancies treated with palliative intent. Results: All 291 included patients lived in The Netherlands; 193 (67.4%) lived fully independent prior to chemotherapy. The median age was 72 years; 164 (56.4%) were male. IADL independence, CGA-based functional status, and QOL were maintained in half of the patients 1 year after chemotherapy. An abnormal G8-score before chemotherapy was a higher risk for progressive disease or a decline of IADL-independence (OR 3.60, 95% CI, 1.98-6.54, P < .0001), prematurely terminated chemotherapy (OR 2.12, 95% CI, 1.24-3.65, P = .006), and shorter median OS (HR 1.71, 95% CI, 1.16-2.52, P = .007). The impact of an abnormal G8-score differed across tumor type (oncological or hematological) and treatment indication (adjuvant or palliative). Conclusion: An abnormal G8 score before chemotherapy is associated with progressive disease and functional decline after chemotherapy and shorter median OS, especially in patients with solid malignancies. (© The Author(s) 2022. Published by Oxford University Press.)
Databáze:	MEDLINE
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