Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, CA, USA.
Patient and Family Resource Center, City of Hope, Duarte, CA, USA.
Oncologist. 2022 Feb 3;27(1):e37-e44. doi: 10.1093/oncolo/oyab016.
Older adults (≥65 years) with gastrointestinal (GI) cancers who receive chemotherapy are at increased risk of hospitalization caused by treatment-related toxicity. Geriatric assessment (GA) has been previously shown to predict risk of toxicity in older adults undergoing chemotherapy. However, studies incorporating the GA specifically in older adults with GI cancers have been limited. This study sought to identify GA-based risk factors for chemotherapy toxicity-related hospitalization among older adults with GI cancers.
We performed a secondary post hoc subgroup analysis of two prospective studies used to develop and validate a GA-based chemotherapy toxicity score. The incidence of unplanned hospitalizations during the course of chemotherapy treatment was determined.
This analysis included 199 patients aged ≥65 years with a diagnosis of GI cancer (85 colorectal, 51 gastric/esophageal, and 63 pancreatic/hepatobiliary). Sixty-five (32.7%) patients had ≥1 hospitalization. Univariate analysis identified sex (female), cardiac comorbidity, stage IV disease, low serum albumin, cancer type (gastric/esophageal), hearing deficits, and polypharmacy as risk factors for hospitalization. Multivariable analyses found that patients who had cardiac comorbidity (OR 2.48, 95% CI 1.13-5.42) were significantly more likely to be hospitalized.
Cardiac comorbidity may be a risk factor for hospitalization in older adults with GI cancers receiving chemotherapy. Further studies with larger sample sizes are warranted to examine the relationship between GA measures and hospitalization in this vulnerable population.
接受化疗的胃肠道（GI）癌症老年患者（≥65 岁）因治疗相关毒性而住院的风险增加。老年评估（GA）先前已被证明可预测接受化疗的老年患者的毒性风险。然而，专门针对胃肠道癌症老年患者的 GA 研究有限。本研究旨在确定胃肠道癌症老年患者基于 GA 的化疗毒性相关住院风险因素。
我们对两项用于开发和验证基于 GA 的化疗毒性评分的前瞻性研究进行了二次事后亚组分析。确定了在化疗过程中发生计划外住院的发生率。
这项分析包括 199 名年龄≥65 岁、诊断为胃肠道癌症（85 例结直肠、51 例胃/食管和 63 例胰腺/肝胆）的患者。65 名（32.7%）患者有≥1 次住院。单因素分析确定了性别（女性）、心脏合并症、IV 期疾病、低血清白蛋白、癌症类型（胃/食管）、听力缺陷和多药治疗是住院的危险因素。多变量分析发现，有心脏合并症的患者（OR 2.48，95%CI 1.13-5.42）更有可能住院。
心脏合并症可能是胃肠道癌症老年患者接受化疗时住院的一个风险因素。需要进一步进行更大样本量的研究，以检查 GA 测量值与该脆弱人群住院之间的关系。
