Predicting chemotherapy toxicity in older adults with cancer: A prospective multicenter study Journal Article
| Authors: | Hurria, A.; Togawa, K.; Mohile, S. G.; Owusu, C.; Klepin, H. D.; Gross, C. P.; Lichtman, S. M.; Gajra, A.; Bhatia, S.; Katheria, V.; Klapper, S.; Hansen, K.; Ramani, R.; Lachs, M.; Wong, F. L.; Tew, W. P. |
| Article Title: | Predicting chemotherapy toxicity in older adults with cancer: A prospective multicenter study |
| Abstract: | Purpose: Older adults are vulnerable to chemotherapy toxicity; however, there are limited data to identify those at risk. The goals of this study are to identify risk factors for chemotherapy toxicity in older adults and develop a risk stratification schema for chemotherapy toxicity. Patients and Methods: Patients age ≥ 65 years with cancer from seven institutions completed a prechemotherapy assessment that captured sociodemographics, tumor/treatment variables, laboratory test results, and geriatric assessment variables (function, comorbidity, cognition, psychological state, social activity/support, and nutritional status). Patients were followed through the chemotherapy course to capture grade 3 (severe), grade 4 (life-threatening or disabling), and grade 5 (death) as defined by the National Cancer Institute Common Terminology Criteria for Adverse Events. Results: In total, 500 patients with a mean age of 73 years (range, 65 to 91 years) with stage I to IV lung (29%), GI (27%), gynecologic (17%), breast (11%), genitourinary (10%), or other (6%) cancer joined this prospective study. Grade 3 to 5 toxicity occurred in 53% of the patients (39% grade 3, 12% grade 4, 2% grade 5). A predictive model for grade 3 to 5 toxicity was developed that consisted of geriatric assessment variables, laboratory test values, and patient, tumor, and treatment characteristics. A scoring system in which the median risk score was 7 (range, 0 to 19) and risk stratification schema (risk score: percent incidence of grade 3 to 5 toxicity) identified older adults at low (0 to 5 points; 30%), intermediate (6 to 9 points; 52%), or high risk (10 to 19 points; 83%) of chemotherapy toxicity (P < .001). Conclusion: A risk stratification schema can establish the risk of chemotherapy toxicity in older adults. Geriatric assessment variables independently predicted the risk of toxicity. © 2011 by American Society of Clinical Oncology. |
| Journal Title: | Journal of Clinical Oncology |
| Volume: | 29 |
| Issue: | 25 |
| ISSN: | 0732-183X |
| Publisher: | American Society of Clinical Oncology |
| Date Published: | 2011-09-01 |
| Start Page: | 3457 |
| End Page: | 3465 |
| Language: | English |
| DOI: | 10.1200/jco.2011.34.7625 |
| PROVIDER: | scopus |
| PUBMED: | 21810685 |
| PMCID: | PMC3624700 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 3 October 2011" - "CODEN: JCOND" - "Source: Scopus" |
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