Department of Respiratory Medicine, Yokohama Municipal Citizen's Hospital, Yokohama, Kanagawa, Japan.
Department of Respiratory Medicine, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
PLoS One. 2019 Jan 17;14(1):e0210499. doi: 10.1371/journal.pone.0210499. eCollection 2019.
The G8 questionnaire is a quick and easy-to-use screening tool. Several studies reported that the G8 questionnaire had a high sensitivity for predicting abnormalities in the full comprehensive geriatric assessment and predicted functional decline and survival in elderly cancer patients. The present study aimed to evaluate the role of the G8 questionnaire for predicting clinical outcomes and overall survival (OS) in elderly patients with lung cancer, who received chemotherapy or chemoradiotherapy. The data of 101 lung cancer patients aged ≥70 years, who were hospitalized between September 2011 and August 2014, were analyzed. Of these patients (median age, 77 years), 83 (82%) had impaired G8 scores. The proportion of patients with an impaired G8 score was significantly higher in patients aged ≥80 years than those aged <80 years (p = 0.04). All 18 patients with a normal G8 score possessed an Eastern Cooperative Oncology Group performance status (ECOG PS) of 0 or 1, and none of the patients with a normal G8 score had an ECOG PS of ≥2 (p < 0.0001). An impaired G8 score tended to correlate with a relative dose intensity of <0.65 in patients who received chemotherapy or chemoradiotherapy (p = 0.05, odds ratio = 5.40). In the univariate analysis, an ECOG PS of ≥2 and an impaired G8 score were significantly associated with a poor OS (p = 0.009 and p = 0.003, respectively). Moreover, in the multivariate analysis, an ECOG PS of ≥2 (HR 2.55; 95% CI, 1.23-5.30; p = 0.01) and an impaired G8 score (HR 3.86; 95% CI, 1.44-13.36; p = 0.006) were remained independent prognostic factor for OS. G8 screening tool is useful for the prognostication of elderly lung cancer patients treated with chemotherapy. These finding suggest that the G8 questionnaire could be a useful tool in treatment decision-making to predict prognosis and prevent patients from receiving inappropriate anti-cancer treatment near the end of life.
G8 问卷是一种快速且易于使用的筛查工具。有几项研究报告称，G8 问卷对于预测全面老年评估中的异常情况具有很高的敏感性，并且可以预测老年癌症患者的功能下降和生存情况。本研究旨在评估 G8 问卷在预测接受化疗或放化疗的老年肺癌患者的临床结局和总生存期（OS）方面的作用。对 2011 年 9 月至 2014 年 8 月期间住院的 101 例年龄≥70 岁的肺癌患者的数据进行了分析。这些患者（中位年龄 77 岁）中，83 例（82%）的 G8 评分受损。年龄≥80 岁的患者中，G8 评分受损的患者比例明显高于年龄<80 岁的患者（p=0.04）。所有 18 例 G8 评分正常的患者的东部合作肿瘤学组表现状态（ECOG PS）为 0 或 1，且无 G8 评分正常的患者的 ECOG PS 为≥2（p<0.0001）。在接受化疗或放化疗的患者中，G8 评分受损与相对剂量强度<0.65 呈正相关（p=0.05，优势比=5.40）。单因素分析显示，ECOG PS≥2 和 G8 评分受损与较差的 OS 显著相关（p=0.009 和 p=0.003）。此外，在多因素分析中，ECOG PS≥2（HR 2.55；95%CI，1.23-5.30；p=0.01）和 G8 评分受损（HR 3.86；95%CI，1.44-13.36；p=0.006）是 OS 的独立预后因素。G8 筛查工具可用于预测接受化疗的老年肺癌患者的预后。这些发现表明，G8 问卷可能是一种有用的工具，可以在治疗决策中预测预后，并防止患者在生命末期接受不适当的抗癌治疗。
