Cancer-specific geriatric assessment and quality of life: important factors in caring for older patients with aggressive B-cell lymphoma
| Autor: | Thomas Pabst, Felicitas Hitz, Karin Ribi, Anastasios Stathis, Natalie Fischer, Ulrich Mey, Stephanie Rondeau, Kerri M. Clough-Gorr, Milica Enoiu |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Lymphoma B-Cell Psychological intervention Aggressive lymphoma 610 Medicine & health 03 medical and health sciences 0302 clinical medicine Quality of life Interquartile range 360 Social problems & social services Internal medicine medicine Humans Prospective Studies Geriatric Assessment Depression (differential diagnoses) Aged Aged 80 and over business.industry Middle Aged Clinical trial Regimen Oncology Tolerability 030220 oncology & carcinogenesis Physical therapy Quality of Life Female business 030215 immunology |
| Zdroj: | Ribi, Karin; Rondeau, Stéphanie; Hitz, Felicitas; Mey, Ulrich; Enoiu, Milica; Pabst, Thomas; Stathis, Anastasios; Fischer, Natalie; Clough-Gorr, Kerri M (2017). Cancer-specific geriatric assessment and quality of life: important factors in caring for older patients with aggressive B-cell lymphoma. Supportive care in cancer, 25(9), pp. 2833-2842. Springer 10.1007/s00520-017-3698-4 |
| Popis: | PURPOSE To evaluate the efficacy and tolerability of chemotherapy, a geriatric assessment is recommended in elderly patients with cancer. We aimed to characterize and compare patients with aggressive lymphoma by objective response and survival status based on pre-treatment cancer-specific geriatric (C-SGA) and quality of life (QoL) assessments. METHODS Patients not eligible for anthracycline-based first-line therapy or intensive salvage regimens completed C-SGA and QoL assessment before and after a rituximab-bendamustine-lenalidomide (R-BL) treatment in a phase II clinical trial. Clinical outcomes were compared based on pre-treatment individual and summary C-SGA measures, their cutoff-based subcategories and QoL indicators, using Wilcoxon rank sum or chi-square tests. RESULTS A total of 57 patients (41 included in the clinical trial) completed a C-SGA. Participants with pre-treatment impaired functional status (Vulnerable Elders Survey-13 score ≥3) were more likely to experience worse outcomes: a higher proportion were non-responders, died before the median follow-up of 31.6 months (interquartile range (IQR) 27.9-37.9) or died during treatment. Non-responders were patients categorized as having possible depression (Geriatric Depression Scale-5 score ≥2) and with worse QoL scores for functional performance. Patients with worse C-SGA summary scores and with greater tiredness were more likely to die during treatment. CONCLUSION A pre-treatment impaired functional status is an important factor with respect to clinical outcomes in patients receiving an R-BL regimen. Individual geriatric and related QoL domains showed similar associations with clinical outcomes. Whether interventions targeting specific geriatric dimensions also translate in better symptom- or domain-specific QoL warrants further research. |
| Databáze: | OpenAIRE |
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