Combination of the G-8 Screening Tool and Hand-Grip Strength to Predict Long-Term Overall Survival in Non-Small Cell Lung Cancer Patients Undergoing Stereotactic Body Radiotherapy

Abstract

The Geriatric 8 (G-8) is a known predictor of overall survival (OS) in older cancer patients, but is mainly based on nutritional aspects. This study aimed to assess if the G-8 combined with a hand-grip strength test (HGST) in patients with NSCLC treated with stereotactic body radiotherapy can predict long-term OS better than the G-8 alone. A total of 46 SBRT-treated patients with NSCLC of stage T1-T2N0M0 were included. Patients were divided into three groups: fit (normal G-8 and HGST), vulnerable (abnormal G-8 or HGST), or frail (abnormal G-8 and HGST). Statistically significant differences were found in 4-year OS between the fit, vulnerable, and frail groups (70% vs. 46% vs. 25%, p = 0.04), as well as between the normal and abnormal G-8 groups (69% vs. 39%, p = 0.02). In a multivariable analysis of OS, being vulnerable with a hazard ratio (HR) of 2.03 or frail with an HR of 3.80 indicated poorer OS, but this did not reach statistical significance. This study suggests that there might be a benefit of adding a physical test to the G-8 for more precisely predicting overall survival in SBRT-treated patients with localized NSCLC. However, this should be confirmed in a larger study population.

Radiation therapy in older patients with cancer

“…En omfattende geriatrisk vurdering (CGA) spiller en vigtig rolle i etableringen af en individuelt tilpasset behandlingsplan for den aeldre patient med kraeft [22]. Flere studier har vist, at størstedelen af aeldre patienter, der modtager strålebehandling, er skrøbelige, men betydningen af CGA hos denne patientgruppe er fortsat ikke fuldstaendigt afklaret [23,24]. En CGA kan formentlig bidrage til individuelle hensyn til gennemførelse af…”

Impact of Stereotactic Body Radiotherapy on Thrombin Generation and Platelet Aggregation in Patients with Non-Small Cell Lung Cancer

“…7,[20][21][22][23] Data indicate that patients with localized NSCLC treated with SBRT die of other causes than lung cancer, one of which may be thromboembolism. [24][25][26] SBRT might further increase the risk of VTE in this group of patients. Thus, the aim of this study was to investigate the impact of SBRT on thrombin generation and platelet aggregation in patients with localized NSCLC.…”

“… 7 , 20 – 23 Data indicate that patients with localized NSCLC treated with SBRT die of other causes than lung cancer, one of which may be thromboembolism. 24 – 26 …”

Geriatric Oncology: From Research to Clinical Practice

“…Several papers in this Special Issue focused on the prediction of outcomes in older adults with cancer. Kirkelund Bentsen et al showed that the combination of G8 with handgrip strength improved the prediction of overall survival in patients with non-small cell lung cancer [ 3 ]. Similarly, Feliu et al showed that geriatric assessment can predict unplanned hospitalizations in patients undergoing chemotherapy [ 4 ].…”