Prediction of Chemotoxicity, Unplanned Hospitalizations and Early Death in Older Patients with Colorectal Cancer Treated with Chemotherapy
Por:
Feliu J, Espinosa E, Basterretxea L, Paredero I, Llabrés E, Jiménez-Munárriz B, Antonio-Rebollo M, Losada B, Pinto A, Custodio AB, Del Mar Muñoz M, Gómez-Mediavilla J, Torregrosa MD, Soler G, Cruz P, Higuera O and Molina-Garrido MJ
Publicada:
1 ene 2022
Ahead of Print:
28 dic 2021
Resumen:
Simple Summary Chemotoxicity, unplanned hospitalizations (Uhs) and early death (ED) are common among older patients with cancer who receive chemotherapy. Our objective was to determine factors predicting these complications. A predictive score for these three complications based on geriatric, tumor and laboratory variables was developed in a series of 215 older patients with colorectal carcinoma receiving chemotherapy. The use of this score may reliably identify patients at risk to have excessive toxicity with chemotherapy, UH or ED, thus helping to plan treatment, implement adaptive measures, and intensify follow-up. Purpose: To identify risk factors for toxicity, unplanned hospitalization (UH) and early death (ED) in older patients with colorectal carcinoma (CRC) initiating chemotherapy. Methods: 215 patients over 70 years were prospectively included. Geriatric assessment was performed before treatment, and tumor and treatment variables were collected. The association between these factors and grade 3-5 toxicity, UH and ED (<6 months) was examined by using multivariable logistic regression. Score points were assigned to each risk factor. Results: During the first 6 months of treatment, 33% of patients developed grade 3-5 toxicity, 31% had UH and 23% died. Risk factors were, for toxicity, instrumental activities of daily living, creatinine clearance, weight loss and MAX2 index; for UH, Charlson Comorbidity Score, creatinine clearance, weight loss, serum albumin, and metastatic disease; and for ED, basic activities in daily living, weight loss, metastatic disease, and hemoglobin levels. Predictive scores were built with these variables. The areas under receiver operation characteristic (ROC) curves for toxicity, UH and ED were 0.70 (95% CI: 0.64-0.766), 0.726 (95% IC: 0.661-0.799) and 0.74 (95% IC: 0.678-0.809), respectively. Conclusion: Simple scores based on geriatric, tumor and laboratory characteristics predict severe toxicity, UH and ED, and may help in treatment planning.
Filiaciones:
Feliu J:
Oncology Department, La Paz University Hospital, IDIPAZ, CIBERONC, UAM-AMGEN Cathedra, 28046 Madrid, Spain
Espinosa E:
Oncology Department, La Paz University Hospital, IDIPAZ, CIBERONC, UAM-AMGEN Cathedra, 28046 Madrid, Spain
Basterretxea L:
Oncology Department, Donostia University Hospital, 20014 Donostia, Spain
:
Oncology Department, Doctor Peset University Hospital, 46017 Valencia, Spain
Llabrés E:
Oncology Department, Insular University Hospital of Gran Canarias, 35016 Las Palmas, Spain
Jiménez-Munárriz B:
Oncology Department, Centro Integral Oncológico Clara Campal, 28050 Madrid, Spain
Antonio-Rebollo M:
Oncohematogeriatrics Unit, Institut Català d'Oncologia, IDIBELL Hospitalet, 08908 Barcelona, Spain
Losada B:
Oncology Department, University Hospital of Fuenlabrada, 28942 Madrid, Spain
Pinto A:
Oncology Department, La Paz University Hospital, IDIPAZ, CIBERONC, UAM-AMGEN Cathedra, 28046 Madrid, Spain
Custodio AB:
Oncology Department, La Paz University Hospital, IDIPAZ, CIBERONC, UAM-AMGEN Cathedra, 28046 Madrid, Spain
Del Mar Muñoz M:
Oncology Department, Hospital Virgen de la Luz, 16002 Cuenca, Spain
Gómez-Mediavilla J:
Oncology Department, Donostia University Hospital, 20014 Donostia, Spain
:
Oncology Department, Doctor Peset University Hospital, 46017 Valencia, Spain
Soler G:
Oncohematogeriatrics Unit, Institut Català d'Oncologia, IDIBELL Hospitalet, 08908 Barcelona, Spain
Cruz P:
Oncology Department, La Paz University Hospital, IDIPAZ, CIBERONC, UAM-AMGEN Cathedra, 28046 Madrid, Spain
Higuera O:
Oncology Department, La Paz University Hospital, IDIPAZ, CIBERONC, UAM-AMGEN Cathedra, 28046 Madrid, Spain
Molina-Garrido MJ:
Oncology Department, Hospital Virgen de la Luz, 16002 Cuenca, Spain
gold, Green Published
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