TY - JOUR
T1 - Geriatric assessment is associated with completion of chemotherapy, toxicity, and survival in older adults with cancer
AU - Wildes, Tanya M.
AU - Ruwe, Alexander P.
AU - Fournier, Chloe
AU - Gao, Feng
AU - Carson, Kenneth
AU - Piccirillo, Jay F.
AU - Tan, Benjamin
AU - Colditz, Graham A.
N1 - Funding Information:
This publication was made possible by Grant Number KM1CA156708-01 through the National Cancer Institute (NCI) at the National Institutes of Health (NIH) and Grant Numbers UL1 TR000448 , KL2 TR000450 , TL1 TR000449 through The Clinical and Translational Science Award (CTSA) program of the National Center for Advancing Translational Sciences (NCATS) at the National Institutes of Health . Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCATS or NIH. The authors wish to acknowledge the support of the Biostatistics Core, Siteman Comprehensive Cancer Center and NCI Cancer Center Support Grant P30 CA091842 .
PY - 2013/7
Y1 - 2013/7
N2 - Objectives: Our purpose was to determine whether geriatric assessments are associated with completion of a chemotherapy course, grade III/IV toxicity or survival in older adults with cancer. Materials and Methods: In this prospective cohort study, patients aged 65. years and older with colorectal, lung, or breast cancer or lymphoma completed a brief geriatric assessment prior to chemotherapy. Endpoints included completion of the planned number of chemotherapy cycles, grade III/IV toxicity and survival. Multivariate logistic regression determined which factors were independently associated with completion of therapy, grade III/IV toxicity or death. Results: Sixty-five patients were enrolled in the study. The median age was 73. years (range 65-89). Geriatric syndromes were common, including depression (21.5%), dependence on others to carry out instrumental activities of daily living (38.5%) and activities of daily living (10.8%), and comorbidities (mild 47.7%, moderate 20%, severe 15.4%). Of the 65 participants, 67.6% completed the planned number of chemotherapy cycles. Curative intent therapy [OR 4.97 (95% CI 1.21-18.81)], Eastern Cooperative Oncology Group (ECOG) performance status 2-3 [OR 0.089 (0.015-0.53)] and renal function [OR 1.03 (1.00-1.06) per ml/min] were significantly associated with therapy completion. Furthermore, 31.1% experienced grade III/IV non-hematologic toxicity. Moderate to severe comorbidities significantly increased the risk of grade III/IV non-hematologic toxicity [OR 6.13 (1.65-22.74)]. Patients who received chemotherapy with curative intent had lower mortality [HR 0.15 (0.06-0.42)], while patients who reported a fall in the month prior to chemotherapy had an increased risk of death [HR 3.20 (1.13-9.11)]. Conclusions: Geriatric assessment is associated with completion of a planned number of cycles of chemotherapy, grade III/IV non-hematologic toxicity, and mortality.
AB - Objectives: Our purpose was to determine whether geriatric assessments are associated with completion of a chemotherapy course, grade III/IV toxicity or survival in older adults with cancer. Materials and Methods: In this prospective cohort study, patients aged 65. years and older with colorectal, lung, or breast cancer or lymphoma completed a brief geriatric assessment prior to chemotherapy. Endpoints included completion of the planned number of chemotherapy cycles, grade III/IV toxicity and survival. Multivariate logistic regression determined which factors were independently associated with completion of therapy, grade III/IV toxicity or death. Results: Sixty-five patients were enrolled in the study. The median age was 73. years (range 65-89). Geriatric syndromes were common, including depression (21.5%), dependence on others to carry out instrumental activities of daily living (38.5%) and activities of daily living (10.8%), and comorbidities (mild 47.7%, moderate 20%, severe 15.4%). Of the 65 participants, 67.6% completed the planned number of chemotherapy cycles. Curative intent therapy [OR 4.97 (95% CI 1.21-18.81)], Eastern Cooperative Oncology Group (ECOG) performance status 2-3 [OR 0.089 (0.015-0.53)] and renal function [OR 1.03 (1.00-1.06) per ml/min] were significantly associated with therapy completion. Furthermore, 31.1% experienced grade III/IV non-hematologic toxicity. Moderate to severe comorbidities significantly increased the risk of grade III/IV non-hematologic toxicity [OR 6.13 (1.65-22.74)]. Patients who received chemotherapy with curative intent had lower mortality [HR 0.15 (0.06-0.42)], while patients who reported a fall in the month prior to chemotherapy had an increased risk of death [HR 3.20 (1.13-9.11)]. Conclusions: Geriatric assessment is associated with completion of a planned number of cycles of chemotherapy, grade III/IV non-hematologic toxicity, and mortality.
KW - Aging
KW - Cancer
KW - Chemotherapy
KW - Geriatric assessment
KW - Geriatrics
KW - Survival
KW - Toxicity
UR - http://www.scopus.com/inward/record.url?scp=84878965576&partnerID=8YFLogxK
U2 - 10.1016/j.jgo.2013.02.002
DO - 10.1016/j.jgo.2013.02.002
M3 - Article
C2 - 23795224
AN - SCOPUS:84878965576
SN - 1879-4068
VL - 4
SP - 227
EP - 234
JO - Journal of Geriatric Oncology
JF - Journal of Geriatric Oncology
IS - 3
ER -