癌症与衰老研究小组化疗毒性计算器对血液系统恶性肿瘤的预测能力。

IF 3 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology Pub Date : 2024-11-05 DOI:10.1016/j.jgo.2024.102144

Ashley E. Rosko , Ying Huang , Sarah A. Wall , Alice Mims , Jennifer Woyach , Carolyn Presley , Nicole O. Williams , Erin Stevens , Claire J. Han , Diane Von Ah , Nowshin Islam , Jessica L. Krok-Schoen , Christin E. Burd , Michelle J. Naughton

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引用次数: 0

摘要

简介：化疗毒性工具很少在血液系统恶性肿瘤（HM）患者中使用。本试验研究的主要目的是确定癌症与老龄化研究小组（CARG）化疗毒性计算器在估计血液恶性肿瘤患者3-5级毒性方面的预测能力：使用 CARG 化疗毒性计算器对 60 岁及以上的 HM 患者进行前瞻性评估。通过在我们的数据中应用已发表的模型，检查了识别性和校准性。此外，我们还在治疗开始和研究结束时纵向采集了全面老年评估（GA）、短期体能测试（SPPB）和健康相关生活质量（HRQoL）。次要目的是探讨GA指标与化疗相关毒性和生存期的关系：共接触了 145 名患者，118 名患者同意接受治疗，97 名患者可接受评估。大多数患者为新诊断患者（n = 91）。CARG 评分中位数为 9（范围为 4-18）。CARG 评分在我们的老年 HM 患者队列中未得到验证，接受者操作特征曲线下面积为 0.53（95 % CI：0.41-0.65）。在多变量分析中，在控制了疾病类型后，与 3-5 级毒性相关的风险因素包括独居（危险比 [HR] 4.24，95 %CI：2.07-8.68，p 讨论）：CARG化疗毒性计算器不能预测血液恶性肿瘤患者的3-5级毒性。在多变量分析中，SPPB 与总生存期相关，这表明它将来可作为一种客观生物标志物用于血液恶性肿瘤。我们还报告了患有 HM 的老年人在功能、生活质量、社会心理健康和认知方面的综合轨迹。CARG化疗毒性计算器的预测准确性可能会受到非传统化疗的多种HM治疗方案的影响。

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Predictive ability of the Cancer and Aging Research Group chemotherapy toxicity calculator in hematologic malignancy

Introduction

Chemotherapy toxicity tools are rarely studied in patients with hematologic malignancy (HM). The primary aim of this pilot study was to determine the predictive ability of the Cancer and Aging Research Group (CARG) chemo-toxicity calculator in estimating grade 3–5 toxicity in patients with HM.

Materials and Methods

Patients 60 years and older with HM were prospectively evaluated using the CARG chemo-toxicity calculator. Discrimination and calibration were checked by applying the published model in our data. Additionally, a full geriatric assessment (GA), the Short Physical Performance Battery (SPPB), and health related quality of life (HRQoL) were captured longitudinally at the start of treatment and at end of study. Secondary aims explored the association of GA metrics with chemo-related toxicities and survival.

Results

One hundred forty-five patients were approached, 118 patients consented, and 97 patients were evaluable. Most patients were newly diagnosed (n = 91). The median CARG score was 9 (range 4–18). The CARG score was not validated in our cohort of older patients with HM, with area under the receiver operation characteristic curve being 0.53 (95 % CI: 0.41–0.65). In multivariable analysis, after controlling for disease type, risk factors associated with grade 3–5 toxicity included living alone (hazard ratio [HR] 4.24, 95 %CI: 2.07–8.68, p < 0.001), increase in body mass index (HR 1.06, 95 %CI: 1.01–1.12, p = 0.03) and a higher social activities score (HR 1.27, 95 %CI: 1.06–1.51, p = 0.01). In multivariable analysis of overall survival, the only prognostic factor was an objective marker of physical function (SPPB score HR = 0.85, 95 %CI:0.78–0.93, p < 0.001).

Discussion

The CARG chemo-toxicity calculator was not predictive of grade 3–5 toxicity in patients with hematologic malignancy. The SPPB was associated with overall survival in multivariable analysis, suggesting future use as an objective biomarker in HM. We also report a comprehensive trajectory of function, QoL, psychosocial well-being, and cognition among older adults with HM. The predictive accuracy of the CARG chemo-toxicity calculator may be affected by the diverse range of HM treatment options that are not traditional chemotherapy.

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来源期刊

Journal of geriatric oncology ONCOLOGY-GERIATRICS & GERONTOLOGY

CiteScore

5.30

自引率

10.00%

发文量

379

审稿时长

80 days

期刊介绍： The Journal of Geriatric Oncology is an international, multidisciplinary journal which is focused on advancing research in the treatment and survivorship issues of older adults with cancer, as well as literature relevant to education and policy development in geriatric oncology. The journal welcomes the submission of manuscripts in the following categories: • Original research articles • Review articles • Clinical trials • Education and training articles • Short communications • Perspectives • Meeting reports • Letters to the Editor.