Radiotherapy, Erasmus Medical Center, Rotterdam, The Netherlands.
Department of Radiotherapy, Haaglanden Medical Center, The Hague, The Netherlands.
Int J Radiat Oncol Biol Phys. 2017 Jul 15;98(4):843-849. doi: 10.1016/j.ijrobp.2017.01.211. Epub 2017 Jan 29.
To investigate whether the Geriatric 8 (G8) and the Timed Get Up and Go Test (TGUGT) and clinical and demographic patient characteristics were associated with acute toxicity of radiation therapy and noncompliance in elderly cancer patients being irradiated with curative intent.
Patients were eligible if aged ≥65 years and diagnosed with breast, non-small cell lung, prostate, head and neck, rectal, or esophageal cancer, and were referred for curative radiation therapy. We recorded acute toxicity and noncompliance and identified potential predictors, including the G8 and TGUGT.
We investigated 402 patients with a median age of 72 years (range, 65-96 years). According to the G8, 44.4% of the patients were frail. Toxicity grade ≥3 was observed in 22% of patients who were frail according to the G8 and 9.1% of patients who were not frail. The difference was 13% (confidence interval 5.2%-20%; P=.0006). According to the TGUGT 18.8% of the patients were frail; 21% of the frail according to the TGUGT developed toxicity grade ≥3, compared with 13% who were not frail. The difference was 7.3% (confidence interval -2.7% to 17%; P=.11). Overall compliance was 95%. Toxicity was most strongly associated with type of primary tumor, chemotherapy, age, and World Health Organization performance status. Compliance was associated with type of primary tumor and age.
The usefulness of the TGUGT and G8 score in daily practice seems to be limited. Type of primary tumor, chemoradiotherapy, age, and World Health Organization performance status were more strongly associated with acute toxicity. Only chemoradiotherapy and age were associated with noncompliance. Overall the compliance was very high. To allow better-informed treatment decisions, a more accurate prediction of toxicity is desirable.
研究老年 8 项（G8）和计时起立行走测试（TGUGT）以及临床和人口统计学患者特征是否与接受根治性放疗的老年癌症患者的急性放射治疗毒性和不依从相关。
如果年龄≥65 岁且被诊断患有乳腺癌、非小细胞肺癌、前列腺癌、头颈部癌、直肠癌或食管癌，并被转诊接受根治性放射治疗，则患者符合条件。我们记录了急性毒性和不依从性，并确定了潜在的预测因素，包括 G8 和 TGUGT。
我们调查了 402 名中位年龄为 72 岁（范围，65-96 岁）的患者。根据 G8，44.4%的患者身体虚弱。根据 G8，44.4%的身体虚弱患者中观察到毒性分级≥3，而身体不虚弱的患者中为 9.1%。差异为 13%（置信区间 5.2%-20%；P=.0006）。根据 TGUGT，18.8%的患者身体虚弱；根据 TGUGT，18.8%的身体虚弱患者发生毒性分级≥3，而身体不虚弱的患者为 13%。差异为 7.3%（置信区间 -2.7%至 17%；P=.11）。总体依从率为 95%。毒性与原发肿瘤类型、化疗、年龄和世界卫生组织表现状态最密切相关。依从性与原发肿瘤类型和年龄相关。
TGUGT 和 G8 评分在日常实践中的有用性似乎有限。原发肿瘤类型、放化疗、年龄和世界卫生组织表现状态与急性毒性的相关性更强。只有放化疗和年龄与不依从相关。总体而言，依从性非常高。为了做出更好的治疗决策，需要更准确地预测毒性。
