The association between social support and chemotherapy-related toxicity in older patients with cancer

Shahrokni, Armin; Sun, Can‐Lan; Tew, William P.; Mohile, Supriya G.; Ma, Hui; Owusu, Cynthia; Klepin, Heidi D.; Gross, Cary P.; Lichtman, Stuart M.; Gajra, Ajeet; Katheria, Vani; Cohen, Harvey Jay; Hurria, Arti

doi:10.1016/j.jgo.2019.08.015

Cited by 12 publications

(7 citation statements)

References 19 publications

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“…However, a prior publication from this cohort has described a relationship between less social support and lower nonhematologic chemotherapy toxicity. 36 Our results build on that observation and may reflect an effect of engaged or proactive caregivers on healthcare utilization. Another possibility is that patients who had more vulnerabilities at start of treatment had already engaged with caregivers for assistance.…”

Section: Discussionsupporting

confidence: 77%

Predictors of Unplanned Hospitalizations Among Older Adults Receiving Cancer Chemotherapy

Klepin

Sun

Smith

et al. 2021

JCO Oncology Practice

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PURPOSE: Hospitalizations during cancer treatment are costly, can impair quality of life, and negatively affect therapy completion. Our objective was to identify risk factors for unplanned hospitalization among older adults receiving chemotherapy. METHODS: This is a secondary analysis of a multisite cohort study (N = 750) of patients ≥ 65 years of age evaluated with a geriatric assessment (GA) to predict chemotherapy toxicity. The primary outcome of this analysis was unplanned hospitalizations during treatment; the secondary outcome was length of stay (LOS) of the first hospitalization. Independent variables included pretreatment GA measures, laboratory values, cancer type and stage, and treatment intensity characteristics. We used logistic regression to estimate the odds of hospitalization and generalized linear models for LOS in multivariable analyses. RESULTS: The sample median age was 72 years (range, 65-94 years); 59% had stage IV disease. At least one unplanned hospitalization occurred in 193 patients (25.7%) during receipt of chemotherapy. In multivariable analyses controlling for cancer type, the following baseline characteristics were significantly associated with increased odds of hospitalization: needing help bathing or dressing (odds ratio [OR], 1.8; 95% CI, 1.0 to 3.1), polypharmacy (≥ 5 meds) (OR, 1.6; 95% CI, 1.1 to 2.4), more comorbid conditions (OR, 1.1; 95% CI, 1.0 to 1.3), availability of someone to take them to the doctor (OR, 2.0; 95% CI, 1.0 to 4.1), CrCl < 60 mL/min (OR, 1.7; 95% CI, 1.1 to 2.4), and albumin < 3.5 g/dL (OR, 1.8; 95% CI, 1.2 to 2.8). In multivariable analyses, older age, self-reported presence of liver or kidney disease, living alone and depressive symptoms were associated with longer LOS. CONCLUSION: Readily available GA variables and laboratory data, but not age, were associated with unplanned hospitalizations among older adults receiving chemotherapy. If validated, these data can inform prediction models and the design of interventions to decrease unplanned hospitalizations.

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Section: Discussionsupporting

confidence: 77%

Predictors of Unplanned Hospitalizations Among Older Adults Receiving Cancer Chemotherapy

Klepin

Sun

Smith

et al. 2021

JCO Oncology Practice

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“… 8 In addition, older adults with cancer are often excluded from randomised clinical trials, limiting the evidence they provide in relation to the benefits and risks of different treatment strategies at older ages. 9 10 Cancer management may also be hindered in older patients with cancer by social factors such as reduced social support 11 12 or healthcare system-related factors such as access to care facilities.…”

Section: Introductionmentioning

confidence: 99%

Patterns of age disparities in colon and lung cancer survival: a systematic narrative literature review

et al. 2021

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ObjectivesTo identify patterns of age disparities in cancer survival, using colon and lung cancer as exemplars.DesignSystematic review of the literature.Data sourcesWe searched Embase, MEDLINE, Scopus and Web of Science through 18 December 2020.Eligibility criteriaWe retained all original articles published in English including patients with colon or lung cancer. Eligible studies were required to be population-based, report survival across several age groups (of which at least one was over the age of 65) and at least one other characteristic (eg, sex, treatment).Data extraction and synthesisTwo independent reviewers extracted data and assessed the quality of included studies against selected evaluation domains from the QUIPS tool, and items concerning statistical reporting. We evaluated age disparities using the absolute difference in survival or mortality rates between the middle-aged group and the oldest age group, or by describing survival curves.ResultsOut of 3047 references, we retained 59 studies (20 for colon, 34 for lung and 5 for both sites). Regardless of the cancer site, the included studies were highly heterogeneous and often of poor quality. The magnitude of age disparities in survival varied greatly by sex, ethnicity, socioeconomic status, stage at diagnosis, cancer site, and morphology, the number of nodes examined and treatment strategy. Although results were inconsistent for most characteristics, we consistently observed greater age disparities for women with lung cancer compared with men. Also, age disparities increased with more advanced stages for colon cancer and decreased with more advanced stages for lung cancer.ConclusionsAlthough age is one of the most important prognostic factors in cancer survival, age disparities in colon and lung cancer survival have so far been understudied in population-based research. Further studies are needed to better understand age disparities in colon and lung cancer survival.PROSPERO registration numberCRD42020151402.

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“…In addition, older adults with cancer are often excluded from randomised clinical trials, limiting the evidence they provide in relation to the benefits and risks of different treatment strategies at older ages 9,10 . Cancer management may also be hindered in older cancer patients by social factors such as reduced social support 11,12 or healthcare system-related factors such as access to care facilities.…”

Section: Introductionmentioning

confidence: 99%

Patterns of age disparities in colon and lung cancer survival: a systematic narrative literature review

Pilleron

Gower

Janssen‐Heijnen

et al. 2020

Preprint

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Objective: To identify patterns of age disparities in cancer survival, using colon and lung cancer as exemplars. Methods: We conducted a systematic review of literature published in EMBASE, MEDLINE, Scopus, and Web of Science according to PRISMA guidelines. We included population-based studies in patients with colon or lung cancer. We assessed the quality of included studies against selected evaluation domains from the QUIPS Tool, and items concerning statistical reporting. We evaluated age disparities using the absolute difference in survival or mortality rates between middle-aged group and the oldest age group, or by describing survival curves. Results: Out of 2,162 references reviewed, we retained 35 studies (15 for colon, 18 for lung, 2 for both sites). Regardless of the cancer site, included studies were highly heterogeneous and often of poor quality. The magnitude of age disparities in survival varied greatly by sex, ethnicity, socio-economic status, stage at diagnosis, cancer site and morphology, the number of nodes examined, and by treatment strategy. Although results were inconsistent for most characteristics, we consistently observed greater age disparities for females with lung cancer compared to males. Also, age disparities increased with more advanced stages for colon cancer and decreased with more advanced stages for lung cancer. Conclusions: Although age is one of the most important prognostic factors in cancer survival, age disparities in colon and lung cancer survival have so far been understudied in population-based research. Further studies are needed to better understand age disparities in colon and lung cancer survival. (PROSPERO registration number: CRD42020151402).

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The association between social support and chemotherapy-related toxicity in older patients with cancer

Cited by 12 publications

References 19 publications

Predictors of Unplanned Hospitalizations Among Older Adults Receiving Cancer Chemotherapy

Predictors of Unplanned Hospitalizations Among Older Adults Receiving Cancer Chemotherapy

Patterns of age disparities in colon and lung cancer survival: a systematic narrative literature review

Patterns of age disparities in colon and lung cancer survival: a systematic narrative literature review

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