Hall William H, Ramachandran Ramanathan, Narayan Samir, Jani Ashesh B, Vijayakumar Srinivasan
University of California, Davis, Department of Radiation Oncology, UC Davis Cancer Center, 4501 X Street, G126, Sacramento, CA 95817, USA.
BMC Cancer. 2004 Dec 20;4:94. doi: 10.1186/1471-2407-4-94.
Uncertainty regarding comorbid illness, and ability to tolerate aggressive therapy has led to minimal enrollment of elderly cancer patients into clinical trials and often substandard treatment. Increasingly, comorbid illness scales have proven useful in identifying subgroups of elderly patients who are more likely to tolerate and benefit from aggressive therapy. Unfortunately, the use of such scales has yet to be widely integrated into either clinical practice or clinical trials research.
This article reviews evidence for the validity of the Charlson Comorbidity Index (CCI) in oncology and provides a Microsoft Excel (MS Excel) Macro for the rapid and accurate calculation of CCI score. The interaction of comorbidity and malignant disease and the validation of the Charlson Index in oncology are discussed.
The CCI score is based on one year mortality data from internal medicine patients admitted to an inpatient setting and is the most widely used comorbidity index in oncology. An MS Excel Macro file was constructed for calculating the CCI score using Microsoft Visual Basic. The Macro is provided for download and dissemination. The CCI has been widely used and validated throughout the oncology literature and has demonstrated utility for most major cancers. The MS Excel CCI Macro provides a rapid method for calculating CCI score with or without age adjustments. The calculator removes difficulty in score calculation as a limitation for integration of the CCI into clinical research. The simple nature of the MS Excel CCI Macro and the CCI itself makes it ideal for integration into emerging electronic medical records systems.
The increasing elderly population and concurrent increase in oncologic disease has made understanding the interaction between age and comorbid illness on life expectancy increasingly important. The MS Excel CCI Macro provides a means of increasing the use of the CCI scale in clinical research with the ultimate goal of improving determination of optimal treatments for elderly cancer patients.
合并症情况的不确定性以及对积极治疗的耐受能力导致老年癌症患者参与临床试验的人数极少，且治疗往往不达标。越来越多的合并症量表已被证明有助于识别更有可能耐受积极治疗并从中获益的老年患者亚组。不幸的是，此类量表的使用尚未广泛纳入临床实践或临床试验研究中。
本文回顾了查尔森合并症指数（CCI）在肿瘤学方面有效性的证据，并提供了一个用于快速准确计算CCI分数的Microsoft Excel宏。讨论了合并症与恶性疾病的相互作用以及查尔森指数在肿瘤学中的验证情况。
CCI分数基于内科住院患者的一年死亡率数据，是肿瘤学中使用最广泛的合并症指数。使用Microsoft Visual Basic构建了一个用于计算CCI分数的MS Excel宏文件。该宏可供下载和传播。CCI在整个肿瘤学文献中已被广泛使用和验证，并已证明对大多数主要癌症有用。MS Excel CCI宏提供了一种快速计算CCI分数的方法，无论是否进行年龄调整。该计算器消除了分数计算困难这一将CCI纳入临床研究的限制。MS Excel CCI宏和CCI本身的简单性使其非常适合集成到新兴的电子病历系统中。
老年人口的增加以及肿瘤疾病的同时增加使得了解年龄和合并症对预期寿命的相互作用变得越来越重要。MS Excel CCI宏提供了一种增加CCI量表在临床研究中使用的方法，最终目标是改善对老年癌症患者最佳治疗方法的确定。
