Department of Therapeutic Radiology and Oncology, Comprehensive Cancer Center, Medical University of Graz, 8036, Graz, Austria.
Outpatient Center for Internal Medicine, PRODOCplus, 8020, Graz, Austria.
Strahlenther Onkol. 2024 Mar;200(3):208-218. doi: 10.1007/s00066-023-02132-3. Epub 2023 Sep 2.
The purpose of the present prospective study was to evaluate the significance of geriatric conditions measured by a comprehensive geriatric assessment (GA) for the prediction of the risk of high-grade acute radiation-induced toxicity.
A total of 314 prostate cancer patients (age ≥ 65 years) undergoing definitive radiotherapy at a tertiary academic center were included. Prior to treatment, patients underwent a GA. High-grade toxicity was defined as acute toxicity grade ≥ 2 according to standard RTOG/EORTC criteria. To analyze the predictive value of the GA, univariable and multivariable logistic regression models were applied.
A total of 40 patients (12.7%) developed acute toxicity grade ≥ 2; high grade genitourinary was found in 37 patients (11.8%) and rectal toxicity in 8 patients (2.5%), respectively. Multivariable analysis revealed a significant association of comorbidities with overall toxicity grade ≥ 2 (odds ratio [OR] 2.633, 95% confidence interval [CI] 1.260-5.502; p = 0.010) as well as with high-grade genitourinary and rectal toxicity (OR 2.169, 95%CI1.017-4.625; p = 0.045 and OR 7.220, 95%CI 1.227-42.473; p = 0.029, respectively). Furthermore, the Activities of Daily Living score (OR 0.054, 95%CI 0.004-0.651; p = 0.022), social status (OR 0.159, 95%CI 0.028-0.891; p = 0.036), and polypharmacy (OR 4.618, 95%CI 1.045-20.405; p = 0.044) were identified as independent predictors of rectal toxicity grade ≥ 2.
Geriatric conditions seem to be predictive of the development of high-grade radiation-induced toxicity in prostate cancer patients treated with definitive radiotherapy.
本前瞻性研究旨在评估综合老年评估（GA）所测量的老年状况对预测高危急性放射性毒性的意义。
共纳入 314 例在三级学术中心接受根治性放疗的前列腺癌患者（年龄≥65 岁）。在治疗前，患者接受了 GA。根据标准 RTOG/EORTC 标准，将重度毒性定义为急性毒性≥2 级。为了分析 GA 的预测价值，应用单变量和多变量逻辑回归模型进行分析。
共有 40 例（12.7%）患者发生急性毒性≥2 级；37 例（11.8%）患者发生高级别泌尿生殖系统毒性，8 例（2.5%）患者发生直肠毒性。多变量分析显示，合并症与总毒性≥2 级（比值比[OR]2.633，95%置信区间[CI]1.260-5.502；p=0.010）以及高级别泌尿生殖系统和直肠毒性（OR 2.169，95%CI1.017-4.625；p=0.045 和 OR 7.220，95%CI 1.227-42.473；p=0.029）显著相关。此外，日常生活活动评分（OR 0.054，95%CI 0.004-0.651；p=0.022）、社会地位（OR 0.159，95%CI 0.028-0.891；p=0.036）和多药治疗（OR 4.618，95%CI 1.045-20.405；p=0.044）是直肠毒性≥2 级的独立预测因素。
老年状况似乎可预测接受根治性放疗的前列腺癌患者发生高危急性放射性毒性。
