Shahrokni Armin, Sun Can-Lan, Tew William P, Mohile Supriya Gupta, Ma Huiyan, Owusu Cynthia, Klepin Heidi D, Gross Cary Philip, Lichtman Stuart M, Gajra Ajeet, Katheria Vani, Cohen Harvey Jay, Hurria Arti
Department of Medicine, Memorial Sloan Kettering Cancer Center, NY, NY, USA.
Department of Supportive Care Medicine, City of Hope, Duarte, CA, USA.
J Geriatr Oncol. 2020 Mar;11(2):274-279. doi: 10.1016/j.jgo.2019.08.015. Epub 2019 Sep 26.
The goal of this study was to evaluate the relationship between social support (SS) and grade 3-5 chemotherapy-related toxicities among older adults with cancer.
This is a secondary analysis of a prospective longitudinal study of patients aged 65+ with solid cancer which led to the development of a predictive model for grade 3-5 chemotherapy-related toxicity (the Cancer and Aging Research Group [CARG] Chemotherapy Toxicity Risk Score). SS was measured by a modified version of Medical-Outcome Study-Social Support Survey and grade 3-5 hematological and non-hematological toxicities were captured and graded using CTCAE version 3.0. Patients were categorized into those with poor (SS score ≤ 75) and good SS (score of 76-100). Multivariate polychotomous logistic regression was used to examine the associations between SS and chemotherapy-related toxicity with adjustment for the CARG Toxicity Risk Score.
Compared to patients with good SS, those with poor SS were less likely to have grade 3-5 toxicity, especially for non-hematological toxicity (adjusted OR = 0.52, p = .02). Patients who did not have someone to take them to the doctor "most" or "all of the time" were less likely to have grade 3-5 non-hematological toxicity compared to patients who had someone to take them to the doctor most or all of the time (adjusted OR = 0.32, p = .02).
Our study showed that patients with poor SS, especially those with less availability of someone to take them to doctors were less likely to have a documented grade 3-5 non-hematological toxicity.
本研究旨在评估老年癌症患者的社会支持（SS）与3-5级化疗相关毒性之间的关系。
这是一项对65岁及以上实体癌患者进行的前瞻性纵向研究的二次分析，该研究促成了3-5级化疗相关毒性预测模型（癌症与衰老研究组[CARG]化疗毒性风险评分）的开发。SS通过改良版的医学结局研究社会支持调查进行测量，3-5级血液学和非血液学毒性使用CTCAE 3.0版进行记录和分级。患者被分为社会支持差（SS评分≤75）和社会支持良好（评分76-100）两组。采用多变量多分类逻辑回归分析，在调整CARG毒性风险评分的情况下，检验SS与化疗相关毒性之间的关联。
与社会支持良好的患者相比，社会支持差的患者发生3-5级毒性的可能性较小，尤其是非血液学毒性（调整后的比值比[OR]=0.52，p=0.02）。与“大部分”或“所有时间”都有人带其就医的患者相比，“大部分”或“所有时间”都无人带其就医的患者发生3-5级非血液学毒性的可能性较小（调整后的OR=0.32，p=0.02）。
我们的研究表明，社会支持差的患者，尤其是无人带其就医的患者，发生3-5级非血液学毒性的记录可能性较小。
