Factors predicting intolerance to definitive conventional radiotherapy in geriatric patients

Rim, Chai Hong; Yoon, Won Sup; Lee, Jung Ae; Yang, Dae Sik; Lee, Nam Kwon; Park, Young Je; Kim, Chul Yong

doi:10.1007/s00066-018-1318-y

Cited by 13 publications

(6 citation statements)

References 32 publications

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“…Low BMI and WL are important criteria for the assessment of cachexia, and age-adjusted BMI is related to treatment-related events. 31 , 32 , 33 According to our results, NCa patients showed significantly higher BMI and lower WL than RCa patients ( P < 0.001). In addition, previous studies showed inflammation as the major cause of WL in patients with cancer 34 and presented the concentration of albumin and C-reactive protein (CRP) as the best predictors of WL.…”

Section: Discussionsupporting

confidence: 53%

R–CSS: A clinically applicable score to classify cachexia stages in patients with cancer undergoing intensity-modulated radiation therapy

Wang

Liang

et al. 2023

Asia-Pacific Journal of Oncology Nursing

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Section: Discussionsupporting

confidence: 53%

R–CSS: A clinically applicable score to classify cachexia stages in patients with cancer undergoing intensity-modulated radiation therapy

Wang

Liang

et al. 2023

Asia-Pacific Journal of Oncology Nursing

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“…These side effects are highly relevant in all patients but may be even more important in the older adult population, where often the emphasis is on quality of life rather than overall survival (OS) [ 8 ]. Therefore, in the older adult population, factors such as medical comorbidities, performance status, and frailty— all of which can increase the probability of treatment-related adverse events—must be carefully considered when making treatment recommendations [ 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Management of Older Adults with Locally Advanced Head and Neck Cancer

Dickstein

Lehrer²,

Hsieh³

et al. 2022

Cancers

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Thirty percent of patients with head and neck squamous cell carcinoma (HNSCC) are at least 70 years of age. This number continues to rise as life expectancy continues to increase. Still, older adults with HNSCC remain underrepresented in clinical trials, resulting in ambiguity on optimal management. Older adults are a complex patient population, often requiring increased support due to issues relating to functional and performance status, medical comorbidities, and medication management. Furthermore, in older adults with HNSCC, many of these conditions are independently associated with increased toxicity and worse outcomes. Toxicity in the older adult remains difficult to predict and to understand, and as treatment decisions are based on treatment tolerability, it is essential to understand the toxicities and how to minimize them. Novel predictive scores are being developed specifically for older adults with HNSCC to understand toxicity and to assist in personalized treatment decisions. There are clinical trials presently underway that are investigating shortened radiation courses and novel, less toxic systemic treatments in this population. In the forthcoming sections, we provide a detailed overview of the clinical data, treatment paradigms, and considerations in this population. This review provides a comprehensive overview of existing clinical data and clinical considerations in the older adult head and neck cancer population. Additionally, we provide a detailed overview of pertinent current and ongoing clinical trials, as well as future areas for investigation.

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“…In this context, one must keep in mind that chronological age should not prevent patients from receiving curative treatment [ 9 ]. The comorbidities that increase the probability of treatment-related adverse events and predict a disadvantageous outcome are of higher importance [ 10 , 11 , 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Predictors for Adherence to Treatment Strategies in Elderly HNSCC Patients

Graessle

Stromberger

Heiland

et al. 2022

Cancers

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Finding a cure may be less important than ensuring the quality of life in elderly patients with head and neck squamous cell carcinoma (HNSCC). The aim of this study was to determine predictors for adherence. Clinical and pathological data from patients ≥70 years with HNSCC (initial diagnoses 2004-2018) were investigated retrospectively. Evaluated clinical predictors included biological age (Charlson Comorbidity Index; CCI), patient health (Karnofsky Performance Status; KPS) and therapy data. A total of 1125 patients were included. The median age was 75 years, 33.1% reached CCI ≥6, and 53.7% reached KPS ≤ 70%. In total, 968 patients were adherent, whereas 157 were nonadherent. Nonadherent patients were significantly more often smokers (p = 0.003), frequent drinkers (p = 0.001), had a worse health status (p ≤ 0.001) and a lower biological age (p = 0.003), an advanced T classification and lymph node involvement or UICC stage (each p ≤ 0.001). Approximately 88.0% of the included patients received a curative treatment recommendation. A total of 6.9% discontinued the therapy, and 7.0% refused the therapy. With the increasing complexity of a recommended therapy, adherence decreased. The 5-year overall survival was significantly higher in adherent patients (45.1% versus 19.2%). In contrast to the chronological patient age, biological age is a significant predictor for adherence. The evaluated predictors for nonadherence need to be verified prospectively.

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Factors predicting intolerance to definitive conventional radiotherapy in geriatric patients

Abstract: Overall, 19.3% of the elderly patients showed treatment intolerance during conventional radiotherapy. Serum albumin level and ECOG performance score should be considered as surrogate markers for radiotherapy interruption prior to the decision regarding definite conventional radiotherapy.

Cited by 13 publications

References 32 publications

R–CSS: A clinically applicable score to classify cachexia stages in patients with cancer undergoing intensity-modulated radiation therapy

R–CSS: A clinically applicable score to classify cachexia stages in patients with cancer undergoing intensity-modulated radiation therapy

Management of Older Adults with Locally Advanced Head and Neck Cancer

Predictors for Adherence to Treatment Strategies in Elderly HNSCC Patients

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