Risk factors for unplanned discontinuation of scheduled treatment in elderly patients with castration-resistant prostate cancer: results of the IBuTu study
Autor: | Friedemann Honecker, Thomas Frangenheim, Gerd Kallischnigg, Jörg Klier, Ulrich Wedding, Axel Schroeder, Lothar Weißbach |
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Rok vydání: | 2018 |
Předmět: |
Male
Cancer Research medicine.medical_specialty Activities of daily living Health Status Comorbidity Drug Administration Schedule Cohort Studies 03 medical and health sciences 0302 clinical medicine Quality of life Risk Factors Internal medicine Activities of Daily Living Antineoplastic Combined Chemotherapy Protocols medicine Humans 030212 general & internal medicine Adverse effect Prospective cohort study Geriatric Assessment Depression (differential diagnoses) Aged Aged 80 and over business.industry Age Factors General Medicine medicine.disease Discontinuation Prostatic Neoplasms Castration-Resistant Withholding Treatment Oncology 030220 oncology & carcinogenesis Quality of Life business Progressive disease |
Zdroj: | Journal of Cancer Research and Clinical Oncology. 144:571-577 |
ISSN: | 1432-1335 0171-5216 |
Popis: | To gain knowledge about the factors associated with discontinuation of scheduled treatment in elderly men with castration-resistant prostate cancer (CRPC). Patients ≥ 70 years with CRPC starting a new line of treatment were included in a prospective cohort study. A geriatric assessment (CGA) was performed at baseline, including comorbidity, mobility, functional/mental/nutritional status, as well as depression. Furthermore, pain intensity, quality of life, ECOG-performance status, and physicians’ and patients’ perception of health were documented. Reasons for and factors associated with discontinuation of scheduled treatment were analysed by univariate and multivariate analysis. After inclusion of 177 of 300 planned patients, the study was closed due to slow recruitment. 160 patients were eligible for final analysis. Median age was 77.5 years. 46% received chemotherapy, and 54% hormonal treatment. Discontinuation of scheduled treatment occurred in 91 patients (57.6%). The main reasons were progressive disease/death in 63%, adverse events/toxicity in 22%, and withdrawal of consent in 8%. In bivariate analyses, factors associated with discontinuation of treatment were age ≥ 80 years, ECOG PS ≥ 2, compromised/poor health status (physicians’/patients’ assessment), and compromised functional or nutritional status. In multivariate analysis, the only remaining factor independently associated with discontinuation of scheduled treatment was impairment of activities of daily living (ADL |
Databáze: | OpenAIRE |
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