Predictive factors of grade 3-5 toxicity in older patients with cancer treated with chemotherapy: A prospective multicenter study.

Abstract

11509 Background: Older patients have increased risk of toxicity from chemotherapy. The purpose of this study was to analyse predictive factors for developing grade 3-5 toxicity in older patients treated with chemotherapy. Methods: This prospective multicenter study included 500 cancer patients ≥ 70 years between Feb 2014 and Jun 2018. A prechemotherapy assessment including sociodemographics, tumor/treatment variables, laboratory test results, and geriatric assessment variables (function, comorbidity, cognition, psychological state, social activity/support, and nutritional status) was performed. Logistic regression was used to examine the association between these factors and the development of grade 3-5 toxicity. Results: Mean age of the patients was 77 years (70-92), ECOG PS 0/1/2: 25%/63%/12%. 223 (45%) had a primary dose reduction.167 (33%) patients developed grade 3-5 toxicity (28% grade 3, 5% grade 4, 1% grade 5). Univariate analysis found a higher risk of grade 3-5 toxicity in patients with creatinine clearance ≤ 60 mL/min, IADL ≤7, VES13 ≥ 6, and the administration of standard chemotherapy doses. In multivariable analysis, only the chemotherapy dose (odds ratio [OR] 1.179; 95% confidence interval [CI] 1.215–2.655) and creatinine clearance (odds ratio [OR] 0.989; 95% confidence interval [CI] 0.981–0.997) were independently associated with toxicity. Conclusions: Renal function and chemotherapy dose were significant predictors of grade 3-5 toxicity among older patients treated with chemotherapy.

Comprehensive geriatric assessment predicts radiation-induced acute toxicity in prostate cancer patients

“…Previous studies have primarily focused on the predictive role of a comprehensive GA for chemotherapy toxicity and have revealed that functional capacity and comorbidities were the factors most frequently linked with toxicity [ 11 , 12 , 29 , 30 ]. For instance, in a study by Hurria et al.…”

Differential Effects of a Telemonitoring Platform in the Development of Chemotherapy-Associated Toxicity: A Randomized Trial Protocol

“…To define severe events associated with chemotherapy, the Common Terminology Criteria for Adverse Events mentioned in the introduction were considered. Events of grades 3 to 5 were categorized as severe [ 11 , 12 ]. Other exploratory secondary outcomes consider the proportion of patients hospitalized due to chemotherapy-related toxicity, the number of visits to emergency services between groups, and the proportion of participants who received a reduction in their chemotherapy doses between groups.…”

“…This method considers six grades of toxicity scored from 0 to 5, where grade 0 denotes the absence of such events, grade 1 is defined as mild, grade 2 is moderate, grade 3 is severe, grade 4 represents toxicity that is life-threatening, and finally, grade 5 is the one causing the patient’s death [ 10 ]. This classification can be categorized into two levels, where toxicity from grade 3 to 5 is high grade and from 0 to 2 is low grade [ 11 , 12 ]. On the other hand, there is growing evidence that patients receiving lower doses of chemotherapy may also see reduced chances of cure and survival compared to those not requiring such dose reduction [ 13 , 14 , 15 , 16 ].…”