Department of Geriatrics, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Dominguez Seccion XVI, Tlalpan, CP 14080 Mexico City, Mexico; City of Hope, 1500 E Duarte Rd, Duarte, CA 91010, United States.
City of Hope, 1500 E Duarte Rd, Duarte, CA 91010, United States.
J Geriatr Oncol. 2018 Mar;9(2):145-151. doi: 10.1016/j.jgo.2017.09.008. Epub 2017 Oct 7.
Older adults with cancer in developing countries face challenges accessing healthcare due to a lack of personnel and infrastructure. A decline in physical activity (defined as a decrease in the number of daily steps) may be a novel method for the timely detection of toxicity in older adults receiving chemotherapy in resource-constrained settings.
In this feasibility study, patients aged ≥65years starting first-line chemotherapy for solid tumors were given a smartphone with a pedometer application. Daily steps were monitored daily for one cycle. If a ≥15% decrease from baseline was identified, the patient was called and the presence of toxicity assessed. The intervention would be feasible if ≥75% of the subjects recorded steps for ≥75% of the planned chemotherapy days.
Forty patients (median age 73; 57% [N=23] female) were included. Seventy percent (N=28) had stage III-IV disease with 45% (N=18) gastrointestinal, 23% (N=9) breast, and 32% (N=13) other malignancies. Mean pre-treatment daily steps was 3111 (Standard Deviation [SD] 1731), and median follow-up was 21days (range 2-28). Despite having limited exposure to mobile technology, most (93%) patients used the smartphone appropriately, and 85% found it easy to use. Sixty percent of patients (N=24) had toxicities managed over the phone, 27.5% (N=10) were sent for urgent medical attention and 15% (N=6) were hospitalized.
Using smartphones to monitor older adults with cancer receiving chemotherapy in a resource-constrained setting is feasible and acceptable. A decrease in the number of daily steps was common and helped to identify chemotherapy toxicity.
发展中国家的老年癌症患者由于人员和基础设施的缺乏，在获得医疗保健方面面临挑战。体力活动减少（定义为日常步数减少）可能是资源有限环境下接受化疗的老年患者及时检测毒性的新方法。
在这项可行性研究中，年龄≥65 岁的开始接受一线化疗治疗实体瘤的患者被提供一部带有计步器应用程序的智能手机。每天监测日常步数，持续一个周期。如果从基线下降≥15%，则会致电患者并评估毒性的存在。如果≥75%的受试者记录了≥75%计划化疗天数的步骤，则该干预措施是可行的。
共有 40 名患者（中位数年龄为 73 岁；57%[N=23]为女性）入选。70%（N=28）患者患有 III-IV 期疾病，其中 45%（N=18）为胃肠道肿瘤，23%（N=9）为乳腺癌，32%（N=13）为其他恶性肿瘤。治疗前每日平均步数为 3111（标准差[SD]1731），中位随访时间为 21 天（范围 2-28）。尽管对移动技术的接触有限，但大多数（93%）患者能够正确使用智能手机，85%的患者认为它易于使用。60%的患者（N=24）通过电话管理毒性，27.5%（N=10）被送往急诊，15%（N=6）住院治疗。
在资源有限的环境中，使用智能手机监测接受化疗的老年癌症患者是可行且可接受的。每日步数减少很常见，有助于识别化疗毒性。
