Baseline comprehensive geriatric assessment is associated with toxicity and survival in elderly metastatic breast cancer patients receiving single-agent chemotherapy: Results from the OMEGA study of the Dutch Breast Cancer Trialists' Group

被引：105

作者：

Hamaker, M. E. ^{[1
]}

Seynaeve, C. ^{[2
]}

Wymenga, A. N. M. ^{[3
]}

van Tinteren, H. ^{[4
]}

Nortier, J. W. R. ^{[5
]}

Maartense, E. ^{[6
]}

de Graaf, H. ^{[7
]}

de Jongh, F. E. ^{[8
]}

Braun, J. J. ^{[9
]}

Los, M. ^{[10
]}

Schrama, J. G. ^{[11
]}

van Leeuwen-Stok, A. E. ^{[12
]}

de Groot, S. M. ^{[13
]}

Smorenburg, C. H.

机构：

[1] Diakonessenhuis Utrecht, Dept Geriatr Med, Utrecht, Netherlands

[2] Erasmus Univ, Med Ctr, Dept Med Oncol, Daniel den Hoed Canc Ctr, Rotterdam, Netherlands

[3] Med Spectrum Twente, Dept Internal Med, Enschede, Netherlands

[4] Antoni van Leeuwenhoek Hosp, NKI, Amsterdam, Netherlands

[5] Leiden Univ, Med Ctr, Dept Med Oncol, Leiden, Netherlands

[6] Reinier de Graaf Hosp, Dept Internal Med, Delft, Netherlands

[7] Med Ctr Leeuwarden, Dept Med Oncol, Leeuwarden, Netherlands

[8] Ikazia Hosp, Dept Internal Med, Rotterdam, Netherlands

[9] Vlietland Hosp, Dept Internal Med, Schiedam, Netherlands

[10] St Antonius Hosp, Dept Internal Med, Nieuwegein, Netherlands

[11] Spaarne Hosp, Dept Internal Med, Hoofddorp, Netherlands

[12] Dutch Breast Canc Trialists Grp BOOG, Amsterdam, Netherlands

[13] Ctr Comprehens Canc, Dutch Breast Canc Trialists Grp BOOG, Amsterdam, Netherlands

来源：

BREAST | 2014年 / 23卷 / 01期

关键词：

Metastatic breast cancer; Palliative chemotherapy; Geriatric assessment; QUALITY-OF-LIFE; DRUG-INTERACTIONS; OLDER; ONCOLOGY; COMORBIDITY; SYSTEM; FRAIL; RISK;

D O I：

10.1016/j.breast.2013.11.004

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Aim: To evaluate the association between baseline comprehensive geriatric assessment (CGA) or the Groningen Frailty Indicator (GFI) and toxicity in elderly metastatic breast cancer (MBC) patients treated with first-line palliative chemotherapy. Patients and methods: MBC patients (>= 65 years) were randomized between pegylated liposomal doxorubicine or capecitabine. CGA included instrumental activities of daily living (IADL), cognition using the mini-mental state examination (MMSE), mood using the geriatric depression scale (GDS), comorbidity using the Charlson index, polypharmacy and nutritional status using the body mass index. Frailty on CGA was defined as one or more of the following: IADL <= 13, MMSE <= 23, GDS >= 5, BMI <= 20, >= 5 medications or Charlson >= 2. The cut-off for frailty on the GFI was >= 4. Results: Of the randomized 78 patients (median age 75.5 years, range 65.8-86.8 years), 73 were evaluable for CGA; 52 (71%) had one or more geriatric conditions. Grade 3-4 chemotherapy-related toxicity was experienced by 19% of patients without geriatric conditions compared to 56% of patients with two geriatric conditions and 80% of those with three or more (p = 0.002). Polypharmacy was the only individual factor significantly associated with toxicity (p = 0.001). GFI had a sensitivity of 69% and a specificity of 76% for frailty on CGA, and was not significantly associated with survival or toxicity. Conclusion: In this study of elderly patients with MBC, the number of geriatric conditions correlated with grade 3-4 chemotherapy-related toxicity. Therefore, in elderly patients for whom chemotherapy is being considered, a CGA could be a useful addition to the decision-making process. (C) 2013 Elsevier Ltd. All rights reserved.

引用

页码：81 / 87

页数：7

共 45 条

[1] Predictive value of geriatric assessment for patients older than 70 years, treated with chemotherapy [J].

Aaldriks, A. A. ;

Maartense, E. ;

le Cessie, S. ;

Giltay, E. J. ;

Verlaan, H. A. C. M. ;

van der Geest, L. G. M. ;

Kloosterman-Boele, W. M. ;

Peters-Dijkshoorn, M. T. ;

Blansjaar, B. A. ;

van Schaick, H. W. ;

Nortier, J. W. R. .

CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY, 2011, 79 (02) :205-212

[2] THE EUROPEAN-ORGANIZATION-FOR-RESEARCH-AND-TREATMENT-OF-CANCER QLQ-C30 - A QUALITY-OF-LIFE INSTRUMENT FOR USE IN INTERNATIONAL CLINICAL-TRIALS IN ONCOLOGY [J].

AARONSON, NK ;

AHMEDZAI, S ;

BERGMAN, B ;

BULLINGER, M ;

CULL, A ;

DUEZ, NJ ;

FILIBERTI, A ;

FLECHTNER, H ;

FLEISHMAN, SB ;

DEHAES, JCJM ;

KAASA, S ;

KLEE, M ;

OSOBA, D ;

RAZAVI, D ;

ROFE, PB ;

SCHRAUB, S ;

SNEEUW, K ;

SULLIVAN, M ;

TAKEDA, F .

JOURNAL OF THE NATIONAL CANCER INSTITUTE, 1993, 85 (05) :365-376

[3] Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100 000 women in 123 randomised trials [J].

Albain, K. ;

Anderson, S. ;

Arriagada, R. ;

Barlow, W. ;

Bergh, J. ;

Bliss, J. ;

Buyse, M. ;

Cameron, D. ;

Carrasco, E. ;

Clarke, M. ;

Correa, C. ;

Coates, A. ;

Collins, R. ;

Costantino, J. ;

Cutter, D. ;

Cuzick, J. ;

Darby, S. ;

Davidson, N. ;

Davies, C. ;

Davies, K. ;

Delmestri, A. ;

Di Leo, A. ;

Dowsett, M. ;

Elphinstone, P. ;

Evans, V. ;

Ewertz, M. ;

Gelber, R. ;

Gettins, L. ;

Geyer, C. ;

Goldhirsch, A. ;

Godwin, J. ;

Gray, R. ;

Gregory, C. ;

Hayes, D. ;

Hill, C. ;

Ingle, J. ;

Jakesz, R. ;

James, S. ;

Kaufmann, M. ;

Kerr, A. ;

MacKinnon, E. ;

McGale, P. ;

McHugh, T. ;

Norton, L. ;

Ohashi, Y. ;

Paik, S. ;

Pan, H. C. ;

Perez, E. ;

Peto, R. ;

Piccart, M. .

LANCET, 2012, 379 (9814) :432-444

[4]

Arnoldi E, 2007, TUMORI J, V93, P23

[5] Biweekly carboplatin/gemcitabine in patients with advanced urothelial cancer who are unfit for cisplatin-based chemotherapy: Report of efficacy, quality of life and geriatric assessment [J].

Bamias, Aristotle ;

Lainakis, George ;

Kastritis, Efstathios ;

Antoniou, Nikos ;

Alivizatos, Gerassimos ;

Koureas, Andreas ;

Chrisofos, Michael ;

Skolarikos, Andreas ;

Karayiotis, Evangelos ;

Dimopoulos, Meletios A. .

ONCOLOGY, 2007, 73 (5-6) :290-297

[6]

Basso U, 2011, J CLIN ONCOL S

[7] Management of Frail and Not-Frail elderly cancer patients in a hospital-based geriatric oncology program [J].

Basso, Umberto ;

Tonti, Singora ;

Bassi, Catia ;

Brunello, Antonella ;

Pasetto, Lara Maria ;

Scaglione, Daniela ;

Falci, Cristina ;

Beda, Manuela ;

Aversa, Savina Maria Luciana ;

Stefani, Micaela ;

Castegnaro, Eugenio ;

Tamellini, Fabio ;

Monfardini, Silvio .

CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY, 2008, 66 (02) :163-170

[8] Drug interactions in oncology [J].

Beijnen, JH ;

Schellens, JHM .

LANCET ONCOLOGY, 2004, 5 (08) :489-496

[9] Quality of life, geriatric assessment and survival in elderly patients with non-small-cell lung cancer treated with carboplatin-gemcitabine or carboplatin-paclitaxel: NVALT-3 a phase III study [J].

Biesma, B. ;

Wymenga, A. N. M. ;

Vincent, A. ;

Dalesio, O. ;

Smit, H. J. M. ;

Stigt, J. A. ;

Smit, E. F. ;

van Felius, C. L. ;

van Putten, J. W. G. ;

Slaets, J. P. J. ;

Groen, H. J. M. .

ANNALS OF ONCOLOGY, 2011, 22 (07) :1520-1527

[10] Drug-drug interactions in oncology: Why are they important and can they be minimized? [J].

Blower, P ;

de Wit, R ;

Goodin, S ;

Aapro, M .

CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY, 2005, 55 (02) :117-142

← 1 2 3 4 5 →