Gebbia Vittorio, Mare Marzia, Cordio Stefano, Valerio Maria Rosaria, Piazza Dario, Bordonaro Roberto, Firenze Alberto, Giuffrida Dario
Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Italy; Medical Oncology Unit, La Maddalena Clinic for Cancer, Italy.
Medical Oncology Unit, Istituto Oncologico del Mediterraneo, Viagrande, Catania, Italy.
J Geriatr Oncol. 2021 Jan;12(1):163-167. doi: 10.1016/j.jgo.2020.06.022. Epub 2020 Jul 8.
This paper aims to analyze the usefulness of the G8 geriatric oncology questionnaire in patients with advanced/metastatic pancreatic adenocarcinoma (aPAC) and its possible association with different clinical outcomes.
Patients age > 70 years were screened with the G8 tool and treated with intravenous nab-paclitaxel 125 mg/m2 and gemcitabine 1000 mg/m2 for 3 consecutive weeks followed by one-week rest as prescribed after clinical evaluation by treating oncologists. Patient's charts were evaluated for type and severity of toxicity, 2 cycle rate of completion, discontinuation rate, delays, dose reductions, and other outcomes response rates, progression-free, and overall survival. Sensitivity, specificity, and possible correlations were analyzed.
Sensitivity and specificity of the G8 score for severe toxicity were respectively 55.9% and 50%. No association between all types of severe grade 3-4 toxicity, delays, or dose reductions, and the G8 score was present (p=0.622). ORR was 32.5% with no complete responses. Median PFS and OS were 4.5 months and 8.1 months, respectively. Correlation between G8 score and PFS was not statistically significant (p=0.0652). Correlation between G8 score and OS was statistically significant (p=0.0251). Although median survival of G8 fit patients was superior to that of G8 vulnerable patients (6.5 versus 4 months), the difference was not statistically different (p=0.1975).
Clinical results in terms of response rate, survival outcomes, and side-effects were in the range reported by others. However, the G8 questionnaire is not a reliable diagnostic tool to predict the risk of severe toxicity, and clinical outcomes in older patients with aPAC.
本文旨在分析G8老年肿瘤学问卷在晚期/转移性胰腺腺癌（aPAC）患者中的实用性及其与不同临床结局的可能关联。
使用G8工具对年龄>70岁的患者进行筛查，并按照治疗肿瘤学家临床评估后规定的方案，给予静脉注射纳米白蛋白结合型紫杉醇125mg/m²和吉西他滨1000mg/m²，连续3周，随后休息1周。评估患者病历中的毒性类型和严重程度、2周期完成率、停药率、延迟、剂量减少以及其他结局反应率、无进展生存期和总生存期。分析敏感性、特异性和可能的相关性。
G8评分对严重毒性的敏感性和特异性分别为55.9%和50%。所有类型的3-4级严重毒性、延迟或剂量减少与G8评分之间均无关联（p=0.622）。客观缓解率为32.5%，无完全缓解。中位无进展生存期和总生存期分别为4.5个月和8.1个月。G8评分与无进展生存期之间的相关性无统计学意义（p=0.0652）。G8评分与总生存期之间的相关性具有统计学意义（p=0.0251）。尽管G8适合患者的中位生存期优于G8易损患者（6.5个月对4个月），但差异无统计学意义（p=0.1975）。
在缓解率、生存结局和副作用方面的临床结果在其他报告的范围内。然而，G8问卷不是预测aPAC老年患者严重毒性风险和临床结局的可靠诊断工具。
