Association between geriatric 8 (G8) scores and self-care decline in elderly patients with head and neck squamous cell carcinoma undergoing radiotherapy.

Abstract

Purpose: Self-care during radiotherapy (RT) is crucial for managing mucositis and dermatitis in patients with head and neck squamous cell carcinomas (HNSCC). However, elderly patients often struggle with self-care. This study examined the relationship between self-care decline and the Geriatric 8 (G8) score.

Methods: A retrospective analysis was conducted on 66 patients (≥ 65 years) with HNSCC who met the inclusion and exclusion criteria and received definitive RT between December 2018 and February 2023. Self-care activities-medication adherence, oral care, grooming, skin ointment application, and gauze dressing-were assessed during definitive RT on a 0-5 scale. Patients were first grouped by initial self-care independence, and their G8 scores were compared. Among initially independent patients, those with self-care score changes were further analyzed based on their G8 scores. A threshold value was also determined to differentiate between the groups.

Results: The initially independent group exhibited significantly higher G8 scores than non-independent group (median G8 score: 14 vs. 9.75, P = 0.0067). Among the initially independent patients, 15 (24.2%) experienced self-care decline, and lower baseline G8 scores significantly predicted this deterioration (median　G8 score: 12 vs. 15; P = 0.011). Multivariate analysis identified G8 scores as a significant predictor of self-care decline (odds ratio = 6.53, P = 0.0074). Receiver operating characteristic (ROC) analysis determined a G8 cutoff of 12 (area under the curve = 0.72) with 53.3% sensitivity and 85.1% specificity.

Conclusion: These findings indicate a possible coherence between the absence of frailty and maintenance of self-care in elderly patients undergoing RT. Further, prospectively designed research is needed to confirm these findings in a larger cohort.