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老年综合评估量表(G8)在预测接受芳香化酶抑制剂治疗的老年患者治疗副作用中的作用。

The role of Geriatric screening tool (G8) in predicting side effect in older patients during therapy with aromatase inhibitor.

机构信息

Institute of Oncology, Policlinico di Monza, Monza, Italy.

Institute of Oncology, Policlinico di Monza, Monza, Italy.

出版信息

J Geriatr Oncol. 2019 Mar;10(2):356-358. doi: 10.1016/j.jgo.2018.10.007. Epub 2018 Oct 14.

Abstract

BACKGROUND

Endocrine therapy is the main treatment in hormonosensitive breast cancer; the most frequent side effects are arthralgia, osteoporosis, depression, dyslipidemia and hypertension. G8 is a simple test developed to identify older patients who could benefit from a comprehensive geriatric assessment (CGA). The aim of this study is to evaluate the possible role of G8 in predicting side effects from treatment with aromatase inhibitor in women ≥65 years old.

MATHERIAL AND METHOD

Women ≥65 years old affected by breast cancer about to start a therapy with an aromatase inhibitor, in the adjuvant setting, were evaluated with the G8 tool. Patients were classified as "fit" with G8 score > 14 or "vulnerable" with G8 score ≤ 14; they then started treatment and clinical-instrumentalfollow-up.

RESULTS

From April 2016 to February 2018, 50 consecutive patients were screened. Median age was 75.1 (range 65-86). G8 identified 30 patients (60%) as "fit" (score > 14) and 20 (40%) as "vulnerable" (score ≤ 14). The grade of concordance between G8 score and the appearance/absence of adverse events were statistically significant (41/50 patients, 82%, p = 0.0002); sensitivity resulted in 78% and specificity was 81%; positive predictive value was 70% and negative predictive value was 87%. The most frequent adverse event was arthromyalgia.

CONCLUSION

The G8 screening tool has a potential role in predicting side effects during a treatment with aromatase inhibitor. G8 could be very useful in everyday clinical practice for this population.

摘要

背景

内分泌治疗是激素敏感型乳腺癌的主要治疗方法;最常见的副作用是关节痛、骨质疏松症、抑郁、血脂异常和高血压。G8 是一种简单的测试方法,用于识别可能受益于全面老年评估(CGA)的老年患者。本研究旨在评估 G8 在预测年龄≥65 岁女性接受芳香化酶抑制剂治疗相关副作用方面的可能作用。

材料和方法

即将开始接受辅助性芳香化酶抑制剂治疗的年龄≥65 岁的乳腺癌女性,用 G8 工具进行评估。患者分为 G8 评分>14 分的“健康”组或 G8 评分≤14 分的“脆弱”组;然后开始治疗并进行临床仪器随访。

结果

从 2016 年 4 月至 2018 年 2 月,连续筛查了 50 例患者。中位年龄为 75.1 岁(范围 65-86 岁)。G8 识别出 30 例(60%)患者为“健康”(评分>14),20 例(40%)患者为“脆弱”(评分≤14)。G8 评分与不良事件的出现/缺失之间的一致性程度具有统计学意义(50 例患者中有 41 例,82%,p=0.0002);敏感性为 78%,特异性为 81%;阳性预测值为 70%,阴性预测值为 87%。最常见的不良事件是关节痛。

结论

G8 筛查工具在预测接受芳香化酶抑制剂治疗期间的副作用方面具有潜在作用。对于这一人群,G8 在日常临床实践中可能非常有用。

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