Association of frailty and chemotherapy-related adverse outcomes in geriatric patients with cancer: a pilot observational study in Taiwan

Ho, Ya-Wen; Tang, Woung-Ru; Chen, Shih‐Ying; Lee, Shu‐Hui; Chen, Jen‐Shi; Hung, Yu‐Shin; Chou, Wen‐Chi

doi:10.18632/aging.203673

Cited by 17 publications

(10 citation statements)

References 37 publications

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“…Although ECOG performance status is not as comprehensive as the CGA (e.g., it does not include measures particularly important in geriatrics such as comorbidities and measures of dependence such as ability to do activities of daily living and independent activities of daily living), multiple studies across many different kinds of malignancies have shown that patients with ECOG‐PS over 1 have higher rates of chemotherapy toxicity and poorer outcomes 29–31 . Research has demonstrated that poor ECOG‐PS correlates with more formal measures of frailty 32,33 . Serum albumin was used as a surrogate for nutritional status, which is linearly associated with frailty 34 and an important concern in the elderly.…”

Section: Discussionmentioning

confidence: 99%

“…[29][30][31] Research has demonstrated that poor ECOG-PS correlates with more formal measures of frailty. 32,33 Serum albumin was used as a surrogate for nutritional status, which is linearly associated with frailty 34 and an important concern in the elderly. Multiple studies have shown that albumin correlates well with malnutrition, with albumin level 3.5 used most often as the lower limit of normal, although inflammation can be a confounding factor.…”

Section: Elderly/frail Classificationmentioning

confidence: 99%

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Efficacy and toxicity of weekly paclitaxel, carboplatin, and cetuximab as induction chemotherapy or in cases of metastases or relapse for head and neck cancer with a focus on elderly or frail patients

et al. 2022

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Background: Paclitaxel, carboplatin, and cetuximab (PCC) has shown promise as induction chemotherapy and in patients with metastatic/recurrent head and neck cancer (HNC). Given its tolerability, the regimen is used in frail and elderly patients.Methods: Software generated the cohort of adult patients with HNC treated with PCC in 2014-2019. Modified RECIST response rate (RR), progression-free survival (PFS), and overall survival (OS) were calculated for the metastatic/ recurrent group, and successful induction rate and RR for the induction group. These were also calculated in the elderly/frail subset (EF): age ≥75, performance status ≥2, albumin <3.5. Results: Fifty-two percent of patients experienced ≥grade 3 toxicities. For metastatic/recurrent disease (N = 58), RR was 22%, mean PFS was 7.1 months.Mean OS was 15.2 months. In the induction cohort (N = 22), 86% reached their endpoint. The RR was 64%. There were no significant differences for EF.Conclusions: PCC is well-tolerated with good induction success rate and reasonable PFS/OS in metastatic/recurrent disease.head and neck cancer, geriatric oncology, induction chemotherapy, metastatic/recurrent head and neck cancer, chemotoxicity

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Section: Discussionmentioning

confidence: 99%

Section: Elderly/frail Classificationmentioning

confidence: 99%

Efficacy and toxicity of weekly paclitaxel, carboplatin, and cetuximab as induction chemotherapy or in cases of metastases or relapse for head and neck cancer with a focus on elderly or frail patients

et al. 2022

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“…This study was part of a prospective, longitudinal and observational study conducted to evaluate the impact of frailty on treatment outcome in cancer patients in Taiwan ( 15 ). The study was carried out at a medical center in northern Taiwan from August 2016 to June 2018.…”

Section: Methodsmentioning

confidence: 99%

“…Frailty was assessed on eight dimensions: functional status,cognition, nutrition, psychological mood, social support, polypharmacy, comorbidity, and history of falls. The detail tool and cutoff standard for each frail condition used in this study has been validated in Taiwanese older cancer patients according to our previous study ( 15 ). Frailty was defined as showing deficits in two or more dimensions according to cancer patient-related frailty literature ( 6 , 14 ).…”

Section: Methodsmentioning

confidence: 99%

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Optimal Frailty Dimensions for Assessing Frailty and Predicting Chemotherapy Adverse Events in Older Taiwanese Cancer Patients

Chen

Hung

et al. 2022

Front. Med.

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BackgroundThis study aimed to investigate the effects of different frailty dimensions on frailty prevalence in older Taiwanese cancer patients receiving chemotherapy, and to analyze the dimensions that should be included in frailty assessment for effectively predicting serious adverse events, unexpected hospitalizations, and emergency department visits.Materials and MethodsThis study prospectively enrolled 234 cancer patients with solid cancer or lymphoma and aged 65 years or older who later received chemotherapy at a medical center in Taiwan from September 2016 to November 2018. First, all patients were subjected to a frailty assessment on eight frailty dimensions within 1 week before their first chemotherapy treatment. The effects of different dimensions on frailty were analyzed using a Poisson regression model. Second, after sequentially excluding one, two, and three dimensions with the lowest effects, frailty was sequentially assessed in the remaining seven, six, and five dimensions for comparison of chemotherapy-related adverse events.ResultsNutritional status, comorbidity, history of falls, cognitive status, and polypharmacy were the top five important dimensions of frailty in older Taiwanese cancer patients. Regardless of the number (five to eight) of dimensions used for frailty assessment, frail patients had higher rates of serious adverse events, unexpected hospitalizations, and emergency room visits than non-frail patients during chemotherapy.ConclusionsFrailty assessment in older Taiwanese cancer patients should be based on at least five dimensions to accurately identify those at high risk of serious adverse events during chemotherapy. It is expected that the present findings may be used to design a frailty scale for older Taiwanese in the future.

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Frailty and Cancer

Ruiz,

Resendes,

Vicens

2024

Frailty

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Association of frailty and chemotherapy-related adverse outcomes in geriatric patients with cancer: a pilot observational study in Taiwan

Cited by 17 publications

References 37 publications

Efficacy and toxicity of weekly paclitaxel, carboplatin, and cetuximab as induction chemotherapy or in cases of metastases or relapse for head and neck cancer with a focus on elderly or frail patients

Efficacy and toxicity of weekly paclitaxel, carboplatin, and cetuximab as induction chemotherapy or in cases of metastases or relapse for head and neck cancer with a focus on elderly or frail patients

Optimal Frailty Dimensions for Assessing Frailty and Predicting Chemotherapy Adverse Events in Older Taiwanese Cancer Patients

Frailty and Cancer

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