Division of Hematology and Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung University, Taoyuan, Taiwan.
School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Aging (Albany NY). 2021 Nov 8;13(21):24192-24204. doi: 10.18632/aging.203673.
With the rapid growth of the elderly population and the increasing incidence of cancer, an increasing number of geriatric patients are receiving cancer treatment, making the selection of appropriate treatment an important issue. Increasing studies have confirmed that frailty can predict adverse outcomes in geriatric patients with cancer after treatment, but local data from Taiwan are lacking. Therefore, this study aimed to investigate the correlation between frailty and chemotherapy-related adverse outcomes in geriatric patients with cancer.
A total of 234 geriatric patients aged ≥65 years with cancer receiving chemotherapy were enrolled during the study period of September 2016 to November 2018. The collected data included: patients' basic demographics and Comprehensive Geriatric Assessment (CGA) before treatment, chemotherapy-related adverse outcomes, unexpected hospitalizations, and emergency department visits within 3 months of treatment. We investigated the association between frailty and chemotherapy-related adverse outcomes in geriatric patients with cancer using the chi-square test and logistic regression analysis.
The prevalence of frailty in geriatric patients with cancer was 58.1%. Age, marital status, main caregiver, cancer type, and Eastern Cooperative Oncology Group performance status, and physical fitness were factors associated with frailty. Frail geriatric patients with cancer were at higher risk of chemotherapy-related adverse outcomes, such as grades 3-4 thrombocytopenia (odds ratio [OR] = 11.13, = 0.021) and grades 3-4 hyponatremia (OR = 12.03, = 0.017), than non-frail patients, and they were at increased risk of unexpected hospitalizations (OR = 2.15, = 0.025) and emergency department visits (OR = 1.99, = 0.039).
Frailty is a common problem in geriatric patients with cancer and significantly impacts chemotherapy-related adverse outcomes. Our findings suggest that geriatric patients with cancer should undergo frail assessment prior to chemotherapy as a reference to guide future treatment decisions.
随着老年人口的快速增长和癌症发病率的不断上升，越来越多的老年患者接受癌症治疗，因此选择合适的治疗方案成为一个重要问题。越来越多的研究证实，衰弱可以预测老年癌症患者治疗后的不良结局，但台湾缺乏本地数据。因此，本研究旨在探讨老年癌症患者衰弱与化疗相关不良结局的相关性。
本研究共纳入 234 名年龄≥65 岁接受化疗的老年癌症患者，研究期间为 2016 年 9 月至 2018 年 11 月。收集的数据包括：患者治疗前的基本人口统计学和综合老年评估（CGA）、化疗相关不良结局、治疗后 3 个月内的意外住院和急诊就诊。我们使用卡方检验和逻辑回归分析调查了老年癌症患者衰弱与化疗相关不良结局之间的关系。
老年癌症患者衰弱的患病率为 58.1%。年龄、婚姻状况、主要照顾者、癌症类型、东部合作肿瘤组表现状态和体能是与衰弱相关的因素。与非衰弱患者相比，虚弱的老年癌症患者发生化疗相关不良结局的风险更高，如 3-4 级血小板减少症（比值比[OR] = 11.13， = 0.021）和 3-4 级低钠血症（OR = 12.03， = 0.017），且意外住院（OR = 2.15， = 0.025）和急诊就诊（OR = 1.99， = 0.039）的风险更高。
衰弱是老年癌症患者的常见问题，显著影响化疗相关不良结局。我们的研究结果表明，老年癌症患者在接受化疗前应进行衰弱评估，作为指导未来治疗决策的参考。
