University Cancer Center, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.
Oncol Res Treat. 2016;39(4):210-6. doi: 10.1159/000445365. Epub 2016 Mar 30.
The aim of this study was to identify an appropriate screening instrument for the identification of frail elderly patients in a tertiary cancer center. In order to improve cancer care for older patients, the use of a geriatric assessment (GA) has been proposed to identify frail patients or those who are at a higher risk for chemotherapy-related toxicities. In busy clinical routine, an appropriate screening instrument could be used to spare time- and resource-consuming application of GA.
We administered the Vulnerable Elders Survey (VES-13), G8 questionnaire, and Predictors of Toxicity (POT) as well as a GA at the first visit of 84 consecutive patients at a single Comprehensive Cancer Center. Analysis for patients' characteristics as well as sensitivity, specificity, and positive and negative predictive value (npv) was conducted.
The median age of the patients was 73 years (range 63-93 years), 61.9% were male, most (63%) suffered from gastrointestinal tumors, 39.3% had a multiple cancer diagnosis, and 53.6% had metastasis. 30 (35.7%) individuals were classified as 'frail' by the GA. Sensitivity of G8 was 38.3%, and the npv was 63.8%. Sensitivity for VES-13 was 57.1%, and npv was 76.3%. Sensitivity of POT was 72.7%, and the npv was 80.6%.
For the first time, the VES-13, G8, and POT are compared in a sample of older German patients. The POT seems to be a sufficient screening tool to identify frail patients in a tertiary referral cancer center and helps to save time and resources compared with a complete GA.
本研究旨在为三级癌症中心的老年患者识别虚弱患者确定合适的筛选工具。为了改善老年患者的癌症治疗，建议使用老年综合评估（GA）来识别虚弱患者或那些有更高化疗相关毒性风险的患者。在繁忙的临床常规中，适当的筛选工具可用于节省时间和资源，避免不必要的 GA 应用。
我们在一家综合性癌症中心对 84 例连续患者的首次就诊时，使用 Vulnerable Elders Survey（VES-13）、G8 问卷、Predictors of Toxicity（POT）以及 GA。分析患者的特征以及敏感性、特异性、阳性和阴性预测值（npv）。
患者的中位年龄为 73 岁（范围 63-93 岁），61.9%为男性，大多数（63%）患有胃肠道肿瘤，39.3%有多种癌症诊断，53.6%有转移。30 例（35.7%）患者被 GA 归类为“虚弱”。G8 的敏感性为 38.3%，npv 为 63.8%。VES-13 的敏感性为 57.1%，npv 为 76.3%。POT 的敏感性为 72.7%，npv 为 80.6%。
这是首次在老年德国患者样本中比较 VES-13、G8 和 POT。与完整的 GA 相比，POT 似乎是一种足够的筛选工具，可用于识别三级转诊癌症中心的虚弱患者，并有助于节省时间和资源。
