Rondan Maria Arnal, Sánchez-Hernández Alfredo, Estellés David Lorente, Sánchez Jóse García, Aparisi Francisco de Asís Aparisi, López Jorge Soler, Benajes Raquel Ten, Sarrió Regina Gironés
Consorcio Hospital Provincial Castellón, Castellón de la Plana, Spain.
Instituto Valenciano de Oncología, Valencia, Spain.
Clin Transl Oncol. 2025 Mar;27(3):1039-1046. doi: 10.1007/s12094-024-03657-4. Epub 2024 Aug 19.
Concurrent chemoradiotherapy (cCRT) is the standard treatment for locally advanced and unresectable non-small-cell lung cancer. Population is aging, and Geriatric assessment (GA) has demonstrated its paper to select fit patients for active treatment and vulnerable, frail patients for interventions and/or palliative care in many histologies. Its role in locally advanced, unresectable non-small-cell lung cancer has been less explored.
To assess the capability of GA to detect frail patients not suitable for active treatment, we developed this exploratory non-interventional prospective study. All patients ≥ 70 years diagnosed with stage locally advanced and unresectable non-small-cell lung cancer were invited to undergo geriatric assessment. Secondary aims were description of population, exploring GA as prognostic factor, determination of toxicity profile and look for a frailty biomarker.
From June 2017 to June 2020, 51 patients were included, of whom 35% (n:18) were classified as frail. Frail patients had less overall survival and more grade 3-4 toxicity. Exploratory results for frailty phenotype are described in the text.
With the results of our study, we confirm that GA can detect frail patients unsuitable for treatment, with a higher risk of toxicity and less overall survival. A trend toward blood-test results for phenotype frailty can be hypothesis generation.
同步放化疗(cCRT)是局部晚期且不可切除的非小细胞肺癌的标准治疗方法。人口正在老龄化,老年评估(GA)已证明其在许多组织学类型中能筛选出适合接受积极治疗的患者以及适合干预和/或姑息治疗的脆弱、体弱患者。其在局部晚期、不可切除的非小细胞肺癌中的作用尚未得到充分探索。
为评估老年评估检测不适合积极治疗的体弱患者的能力,我们开展了这项探索性非干预性前瞻性研究。邀请所有年龄≥70岁、被诊断为局部晚期且不可切除的非小细胞肺癌患者接受老年评估。次要目标包括描述患者群体、探索老年评估作为预后因素、确定毒性特征以及寻找衰弱生物标志物。
2017年6月至2020年6月,共纳入51例患者,其中35%(n = 18)被归类为体弱。体弱患者的总生存期较短,3 - 4级毒性反应较多。文中描述了衰弱表型的探索性结果。
根据我们的研究结果,我们证实老年评估能够检测出不适合治疗的体弱患者,这些患者毒性风险较高且总生存期较短。血液检测结果显示出衰弱表型的趋势可用于提出假设。