Warren Alpert Medical School of Brown University, Division of Geriatrics and Palliative Medicine, Brown Medicine, Providence, RI.
Center of Innovation in Long Term Services and Supports, VA Providence Healthcare System, Providence, RI; Division of Geriatrics and Palliative Medicine, Warren Alpert Medical School of Brown University and Center of Gerontology and Health Services Research, Brown University School of Public Health, Providence, RI.
R I Med J (2013). 2023 May 1;106(4):13-18.
Multidisciplinary Geriatric-Oncology (GO-MDC) clinic performed comprehensive geriatric assessment (CGA) to determine frailty and chemotherapy toxicity risk.
Retrospective cohort study of patients ≥65 years seen between April 2017 to March 2022. We compared Eastern Cooperative Oncology Group-Performance Status (ECOG-PS) to CGA as a determinant of frailty and risk of toxicity from chemotherapy.
Mean age of the 66 patients was 79 years. Eighty-five percent were Caucasian. Predominant cancers were breast (30%), and gynecological (26%). One-third were stage 4. The CGA identified fit (35%), vulnerable (48%), and frail (17%) patients whereas ECOG-PS classified 80% as fit. CGA assessed 57% of ECOG-fit patients as vulnerable or frail (p<0.001). High chemotherapy toxicity risk using CGA was 41% and using ECOG was 17% (p=0.002).
At GO-MDC, CGA was a better predictor of frailty and toxicity risk than ECOG-PS. Treatment modification was recommended in one-third of patients.
多学科老年肿瘤学（GO-MDC）诊所进行了全面的老年评估（CGA），以确定虚弱和化疗毒性风险。
对 2017 年 4 月至 2022 年 3 月期间就诊的≥65 岁患者进行回顾性队列研究。我们比较了东部合作肿瘤学组表现状态（ECOG-PS）和 CGA 作为确定虚弱和化疗毒性风险的因素。
66 例患者的平均年龄为 79 岁。85%为白种人。主要癌症为乳腺癌（30%）和妇科癌症（26%）。三分之一为 4 期。CGA 将患者分为健康（35%）、脆弱（48%）和虚弱（17%），而 ECOG-PS 将 80%的患者分类为健康。CGA 评估 80%的 ECOG 健康患者为脆弱或虚弱（p<0.001）。使用 CGA 的高化疗毒性风险为 41%，而使用 ECOG 的为 17%（p=0.002）。
在 GO-MDC，CGA 是虚弱和毒性风险的更好预测因素，而 ECOG-PS 则不是。建议对三分之一的患者进行治疗调整。
