Shen Xiaoying, Qi Xiaofang, Fu Xiaowei
Zhejiang Cancer Hospital, Hangzhou Institute of Medicine (HIM), Chinese Academy of Sciences, Hangzhou, China.
Transl Cancer Res. 2025 Jun 30;14(6):3642-3653. doi: 10.21037/tcr-2025-324. Epub 2025 Jun 27.
Elderly patients with thoracic tumors, including lung, esophageal, or mediastinal malignancies, encounter distinct challenges when undergoing radiotherapy (RT) due to age-related frailty. Research has identified several factors that influence RT outcomes in this patient population. These factors encompass age, comorbidities, polypharmacy, types and duration of physical activity, albumin levels, psychological distress, and sleep disorders. The objective of this study was to offer a reference for the management and intervention of frailty in patients with tumors.
The Chinese version of the Tilburg Frailty Index, known as the General Information Questionnaire and the Oral Frailty Screening Scale were used to assess 139 patients aged 60 years and above who were scheduled to undergo RT for thoracic tumors at Zhejiang Cancer Hospital. Multiple linear regression analysis was used to identify the factors influencing pre-RT frailty in these patients.
Among the pre-RT patients with thoracic tumors included in this study, 28.1% were classified as frail, with an overall frailty score of 3.75±2.429. This encompassed social frailty (1.56±0.772), psychological frailty (0.68±0.965), physical frailty (1.51±1.525), and oral frailty (3.38±1.987). The primary factors influencing pre-RT frailty in elderly patients with thoracic tumors were age, comorbidities, multiple medications, exercise type and duration, albumin levels, psychological distress, and sleep disturbances.
Elderly patients with thoracic tumors exhibit varying degrees of frailty across physical, social, psychological, and oral dimensions, with social and psychological frailty being particularly prominent. Elderly patients who were of advanced age, with multiple chronic diseases, taking multiple medications, engaging in limited resistance exercise, and having low albumin levels are especially vulnerable to frailty. Healthcare providers should prioritize the assessment of frailty in these patients and promptly implement comprehensive and feasible interventions to prevent or mitigate the onset and progression of frailty.
患有胸部肿瘤（包括肺癌、食管癌或纵隔恶性肿瘤）的老年患者，由于与年龄相关的身体虚弱，在接受放射治疗（RT）时面临独特的挑战。研究已经确定了几个影响该患者群体放疗结果的因素。这些因素包括年龄、合并症、多种药物治疗、身体活动的类型和持续时间、白蛋白水平、心理困扰和睡眠障碍。本研究的目的是为肿瘤患者虚弱的管理和干预提供参考。
使用蒂尔堡虚弱指数的中文版，即一般信息问卷和口腔虚弱筛查量表，对139例年龄在60岁及以上、计划在浙江省肿瘤医院接受胸部肿瘤放疗的患者进行评估。采用多元线性回归分析确定影响这些患者放疗前虚弱的因素。
在本研究纳入的放疗前胸部肿瘤患者中，28.1%被归类为虚弱，总体虚弱评分为3.75±2.429。这包括社会虚弱（1.56±0.772）、心理虚弱（0.68±0.965）、身体虚弱（1.51±1.525）和口腔虚弱（3.38±1.987）。影响老年胸部肿瘤患者放疗前虚弱的主要因素是年龄、合并症、多种药物、运动类型和持续时间、白蛋白水平、心理困扰和睡眠障碍。
老年胸部肿瘤患者在身体、社会、心理和口腔维度上表现出不同程度的虚弱，其中社会和心理虚弱尤为突出。年龄较大、患有多种慢性病、服用多种药物、进行有限的抗阻运动且白蛋白水平较低的老年患者尤其容易出现虚弱。医疗保健提供者应优先评估这些患者的虚弱情况，并及时实施全面可行的干预措施，以预防或减轻虚弱的发生和进展。
