Integrating Frailty Assessment to Enhance Care in Cancer Patients with Borderline Eastern Cooperative Oncology Group Performance Status.

Chih-Chung Hsu, Yu-Shin Hung, Shao-Ming Yu, Shun-Wen Hsueh, Wen-Chi Chou
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Abstract

Background: The (ECOG) performance status (PS) is commonly used to evaluate the functional ability of patients undergoing antitumor therapy. An ECOG PS of 2, indicating patients capable of self-care but restricted strenuous activity, can complicate treatment decisions owing to concerns regarding treatment-related toxicity. We investigated whether frailty assessment could help discriminate treatment tolerance and survival outcomes in patients with an ECOG PS of 2.

Methods: We prospectively included 45 consecutive patients, aged ≥65 years, with an ECOG PS of 2, and newly diagnosed solid cancer scheduled for chemotherapy. Frailty was assessed using an eight-indicator geriatric assessment. The primary outcome was overall survival (OS) based on frailty status; secondary outcomes included treatment tolerance and toxicity.

Results: The median patient age was 73 years (range 65-94), and 71% had stage IV disease. Predominant frailty-related deficits were functional decline (96%), malnutrition (78%), and polypharmacy (51%). The median OS was 12.6 months (95% confidence interval [CI]: 6.8-18.4). Patients with 4-6 deficits had significantly lower OS than those with 1-3 deficits (9.9 months vs. 20.0 months, adjusted hazard ratio 2.51, 95% CI: 1.16-5.44, P = .020). Frailty significantly correlated with reduced 12-week chemotherapy competence (52% vs. 85%, adjusted odds ratio [OR] .14, 95% CI: .03-.70, P = .016) and enhanced risk of unexpected hospitalization (60% vs. 20%, adjusted OR 6.80, 95% CI: 1.64-28.1, P = .008).

Conclusion: Our findings highlight the multifaceted nature of patients with an ECOG PS of 2 and emphasize the importance of frailty assessment for treatment outcomes.

整合虚弱评估,加强对东部合作肿瘤学组表现状态处于边缘的癌症患者的护理。
背景:ECOG)表现状态(PS)通常用于评估接受抗肿瘤治疗的患者的功能能力。ECOG PS 为 2 表示患者有自理能力,但剧烈活动受限,这可能会使治疗决策复杂化,因为人们担心治疗相关毒性。我们研究了虚弱程度评估是否有助于区分 ECOG PS 为 2 的患者的治疗耐受性和生存结果:我们前瞻性地纳入了 45 名年龄≥65 岁、ECOG PS 为 2、新诊断为实体瘤并计划接受化疗的连续患者。采用老年医学八项指标评估虚弱程度。主要结果是基于虚弱状态的总生存期(OS);次要结果包括治疗耐受性和毒性:患者年龄中位数为 73 岁(65-94 岁不等),71% 的患者处于 IV 期。与虚弱相关的主要缺陷是功能衰退(96%)、营养不良(78%)和多药治疗(51%)。中位生存期为 12.6 个月(95% 置信区间 [CI]:6.8-18.4)。有 4-6 项缺陷的患者的 OS 明显低于有 1-3 项缺陷的患者(9.9 个月 vs. 20.0 个月,调整后危险比 2.51,95% 置信区间 [CI]:1.16-5.44,P = .020)。体弱与12周化疗能力下降(52% vs. 85%,调整后比值比 [OR] .14,95% CI:.03-.70,P = .016)和意外住院风险增加(60% vs. 20%,调整后比值比 6.80,95% CI:1.64-28.1,P = .008)明显相关:我们的研究结果突出了 ECOG PS 为 2 的患者的多面性,强调了虚弱评估对治疗结果的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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