Han Claire J, Rosko Ashley E, Plascak Jesse J, Tan Alai, Noonan Anne M, Burd Christin E
Center for Healthy Aging, Self-Management and Complex Care, The Ohio State University College of Nursing, The Ohio State University-James: Cancer Treatment, and Research Center, Columbus, OH 43210, USA.
Division of Hematology, The Ohio State University, Columbus, OH 43210, USA.
Curr Oncol. 2025 Aug 5;32(8):438. doi: 10.3390/curroncol32080438.
: Biological aging influences cancer outcomes, but its changes during chemotherapy and impact on chemotoxicity in colorectal cancer (CRC) remain underinvestigated. We examined (1) trajectories of biological aging (using Levine Phenotypic Age) during six months of chemotherapy, (2) sociodemographic and clinical risk factors for biological aging, and (3) links between biological aging and chemotoxicity. Using data from electronic health records (2013-2019) from 1129 adult CRC patients, we computed biological aging (raw Levine Phenotypic Age and its age acceleration [Levine Phenotypic Age-chronological age]) from routine blood tests (e.g., complete blood counts, hepatorenal/inflammatory markers). Chemotoxicity was identified primarily via International Classification of Diseases (ICD-9 and -10) codes. Chemotherapy accelerated biological aging over time. Biological aging at baseline and changes over time predicted chemotoxicity. However, changes in biological aging over time showed stronger associations than baseline biological aging. Advanced cancer stages, higher comorbidity burden, and socioeconomic disadvantage (especially area-level deprivation) were associated with accelerated biological aging at baseline and over time. Biological aging occurred across both young and older adults. Levine Phenotypic Age, computed from routine blood tests in EHRs, offers a feasible clinical tool for aging-related chemotoxicity risk stratification. Validation in diverse cohorts and the development of predictive models are needed.
生物衰老影响癌症预后，但其在化疗期间的变化以及对结直肠癌（CRC）化学毒性的影响仍未得到充分研究。我们研究了：（1）化疗六个月期间生物衰老的轨迹（使用莱文表型年龄）；（2）生物衰老的社会人口统计学和临床风险因素；（3）生物衰老与化学毒性之间的联系。利用1129名成年CRC患者的电子健康记录（2013 - 2019年）数据，我们通过常规血液检测（如全血细胞计数、肝肾/炎症标志物）计算生物衰老（原始莱文表型年龄及其年龄加速[莱文表型年龄 - 实际年龄]）。化学毒性主要通过国际疾病分类（ICD - 9和 - 10）编码确定。化疗会随着时间加速生物衰老。基线时的生物衰老及其随时间的变化可预测化学毒性。然而，生物衰老随时间的变化比基线生物衰老显示出更强的相关性。癌症晚期、更高的合并症负担以及社会经济劣势（尤其是地区层面的贫困）与基线时和随时间加速的生物衰老相关。生物衰老在年轻人和老年人中均会发生。从电子健康记录中的常规血液检测计算得出的莱文表型年龄，为与衰老相关的化学毒性风险分层提供了一种可行的临床工具。需要在不同队列中进行验证并开发预测模型。
