老年癌症患者财务毒性的患病率和影响：印度的一项前瞻性观察研究。

IF 2.8 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Supportive Care in Cancer Pub Date : 2025-04-25 DOI:10.1007/s00520-025-09252-9

Vanita Noronha, Arnav Tongaonkar, Anupa Pillai, Abhijith Rajaram Rao, Anita Kumar, Arshiya Sehgal, Renee Basu, Anant Ramaswamy, Ratan Dhekale, Anuradha Daptardar, Lekhika Sonkusare, Manjusha Vagal, Purabi Mahajan, Manjunath Nookala, Ankita Chitre, Vikram Gota, Oindrila Roy Chowdhury, Ankush Shetake, Aruni Ghose, Shripad Banavali, Rajendra Badwe, Kumar Prabhash

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引用次数: 0

摘要

目的：我们旨在评估印度老年癌症患者的财务毒性患病率，并评估其与生活质量（QoL）、焦虑、老年评估中的脆弱性以及影响财务毒性的因素的关系。方法：这是一项在塔塔纪念中心（印度孟买）进行的前瞻性观察研究，研究对象为60岁及以上的患者，计划进行癌症定向治疗。我们使用成本-事实和CFPB财务健康量表来评估财务毒性。生活质量采用欧洲癌症研究与治疗组织（EORTC） QLQ C30问卷进行评估，痛苦程度采用NCCN痛苦温度计进行评估。结果：在2022年6月至2023年9月期间，我们招募了953名患者。中位年龄66岁（IQR 63-72）；70岁以上患者277例（29.1%），男性737例（77.3%），有健康保险135例（14.2%）。607例（63.7%）患者计划姑息治疗。根据成本-事实量表（n = 703），金融毒性的患病率为73.7%，根据CFPB （n = 629）为66%。成本-事实量表上较高的财务毒性与CFPB量表上较差的财务状况有关。财务毒性与较差的生活质量和较高的痛苦有关。与财务毒性显著增加相关的因素包括咀嚼烟草史、家庭月收入低于5万卢比、缺乏健康保险、文盲、抑郁症和认知障碍。结论：确定导致财务毒性的因素将有助于使癌症治疗过程更顺利，更容易获得，并提高老年患者对治疗的依从性。临床试验注册：ClinicalTrials.gov标识符：CTRI/2020/04/024675。

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Prevalence and impact of financial toxicity in older patients with cancer: a prospective observational study in India.

Purpose: We aimed to assess the prevalence of financial toxicity in older Indian patients with cancer and evaluate the association with quality of life (QoL), distress, vulnerabilities in the geriatric assessment, and factors impacting financial toxicity.

Methods: This was a prospective observational study at the Tata Memorial Center (Mumbai, India) in patients aged 60 years and over, planned for cancer-directed therapy. We used the COST-FACIT and CFPB Financial Well-Being Scales to assess financial toxicity. QoL was assessed with the European Organization for Research and Treatment of Cancer (EORTC) QLQ C30 questionnaire, and distress with the NCCN distress thermometer.

Results: Between June 2022 and September 2023, we enrolled 953 patients. The median age was 66 (IQR 63-72) years; 277 patients (29.1%) were over 70 years old, 737 (77.3%) were male, and 135 (14.2%) had health insurance. Therapy was planned with palliative intent in 607 (63.7%) patients. The prevalence of financial toxicity was 73.7% as per the COST-FACIT scale (n = 703), and 66% as per the CFPB (n = 629). Higher financial toxicity on the COST-FACIT scale was associated with poor financial well-being on the CFPB scale. Financial toxicity was associated with poor QoL and higher distress. Factors associated with significantly greater financial toxicity included history of tobacco chewing, monthly family income less than ₹50,000, lack of health insurance, illiteracy, depression, and cognitive impairment.

Conclusions: Identifying the factors contributing to financial toxicity will help make the cancer treatment journey smoother, more accessible and improve compliance to therapy for older patients.

Clinical trial registration: ClinicalTrials.gov Identifier: CTRI/2020/04/024675.

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来源期刊

Supportive Care in Cancer 医学-康复医学

CiteScore

5.70

自引率

9.70%

发文量

751

审稿时长

3 months

期刊介绍： Supportive Care in Cancer provides members of the Multinational Association of Supportive Care in Cancer (MASCC) and all other interested individuals, groups and institutions with the most recent scientific and social information on all aspects of supportive care in cancer patients. It covers primarily medical, technical and surgical topics concerning supportive therapy and care which may supplement or substitute basic cancer treatment at all stages of the disease. Nursing, rehabilitative, psychosocial and spiritual issues of support are also included.