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老年前列腺癌患者的预测性综合老年评估:前瞻性观察性SCOOP试验结果

Predictive Comprehensive Geriatric Assessment in elderly prostate cancer patients: the prospective observational scoop trial results.

作者信息

Della Pepa Chiara, Cavaliere Carla, Rossetti Sabrina, Di Napoli Marilena, Cecere Sabrina C, Crispo Anna, De Sangro Carlo, Rossi Emanuela, Turitto Dino, Germano Domenico, Iovane Gelsomina, Berretta Massimiliano, D'Aniello Carmine, Pisconti Salvatore, Maiorino Luigi, Daniele Bruno, Gridelli Cesare, Pignata Sandro, Facchini Gaetano

机构信息

aDivision of Medical Oncology, Department of Uro-Gynaecological Oncology 'Istituto Nazionale Tumori' 'Fondazione G. Pascale'-IRCCS bUnit of Epidemiology, 'Istituto Nazionale Tumori' 'Fondazione G. Pascale' - IRCCS cDivision of Medical Oncology, 'San Gennaro dei Poveri' Hospital, Naples dDepartment of Onco-Ematology and Medical Oncology, S.G. Moscati Hospital of Taranto, Taranto eDivision of Medical Oncology, 'San Giuseppe Moscati' Hospital, Avellino fDivision of Medical Oncology, 'Gaetano Rummo' Hospital, Benevento gDepartment of Medical Oncology, National Cancer Institute, Aviano, Italy.

出版信息

Anticancer Drugs. 2017 Jan;28(1):104-109. doi: 10.1097/CAD.0000000000000428.

Abstract

The Comprehensive Geriatric Assessment (CGA) represents the future of the geriatric oncology to reduce toxicities and treatment-related hospitalization in the elderly. Most patients receiving docetaxel for metastatic castration-resistant prostate cancer are in their seventies or older. We explored the efficacy of the CGA in predicting chemotherapy feasibility and response to docetaxel in a cohort of 24 patients aged at least 70. This was an observational, prospective study involving 24 patients who were 70 years of age or older and about to start chemotherapy with docetaxel for metastatic castration-resistant prostate cancer; we performed a CGA including five domains and divided our patients into 'healthy' and 'frail'; the relations between general condition and (i) early chemotherapy discontinuation and (ii) response to docetaxel were explored. We found a statistically significant relationship between frailty assessed by CGA and early docetaxel discontinuation; we also found an association between frailty and response to chemotherapy, but this did not reach statistical significance. A geriatric assessment before starting chemotherapy may help clinicians to recognize frail patients, and hence to reduce toxicities and early treatment discontinuation. Further analyses are required to simplify the CGA tools and to facilitate its incorporation into routine clinical practice.

摘要

综合老年评估(CGA)代表了老年肿瘤学的未来发展方向,有助于降低老年人的毒性反应和与治疗相关的住院率。大多数接受多西他赛治疗转移性去势抵抗性前列腺癌的患者年龄在七十多岁或更大。我们在一组24名年龄至少70岁的患者中探索了CGA在预测化疗可行性及对多西他赛反应方面的疗效。这是一项观察性前瞻性研究,涉及24名70岁及以上且即将开始使用多西他赛治疗转移性去势抵抗性前列腺癌的患者;我们进行了包括五个领域的CGA,并将患者分为“健康”和“虚弱”两组;探讨了一般状况与(i)早期化疗中断和(ii)对多西他赛反应之间的关系。我们发现通过CGA评估的虚弱与早期停用多西他赛之间存在统计学上的显著关系;我们还发现虚弱与化疗反应之间存在关联,但未达到统计学显著性。化疗开始前进行老年评估可能有助于临床医生识别虚弱患者,从而降低毒性反应和早期治疗中断的发生率。需要进一步分析以简化CGA工具并促进其纳入常规临床实践。

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