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J Geriatr Oncol. 2013 Jul;4(3):227-34.

Geriatric assessment is associated with completion of chemotherapy, toxicity, and survival in older adults with cancer.

Abstract

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 nonhematologic 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 themonth prior to chemotherapy had an increased risk of death [HR 3.20 (1.13–9.11)].

CONCLUSIONS:

Geriatric assessment is associatedwith completion of a planned number of cycles of chemotherapy, grade III/IV non-hematologic toxicity, and mortality.

PMID:
23795224
[PubMed - indexed for MEDLINE]
PMCID:
PMC3686522
Free PMC Article
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