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Observational Study
. 2021 Nov 8;13(21):24192-24204.
doi: 10.18632/aging.203673. Epub 2021 Nov 8.

Association of frailty and chemotherapy-related adverse outcomes in geriatric patients with cancer: a pilot observational study in Taiwan

Ya-Wen Ho  1   2 , Woung-Ru Tang  2 , Shih-Ying Chen  2 , Shu-Hui Lee  3 , Jen-Shi Chen  1 , Yu-Shin Hung  1 , Wen-Chi Chou  1
Affiliations
Observational Study

Association of frailty and chemotherapy-related adverse outcomes in geriatric patients with cancer: a pilot observational study in Taiwan

Ya-Wen Ho et al. Aging (Albany NY). .

Abstract

Background: With the rapid growth of the elderly population and the increasing incidence of cancer, an increasing number of geriatric patients are receiving cancer treatment, making the selection of appropriate treatment an important issue. Increasing studies have confirmed that frailty can predict adverse outcomes in geriatric patients with cancer after treatment, but local data from Taiwan are lacking. Therefore, this study aimed to investigate the correlation between frailty and chemotherapy-related adverse outcomes in geriatric patients with cancer.

Material and methods: A total of 234 geriatric patients aged ≥65 years with cancer receiving chemotherapy were enrolled during the study period of September 2016 to November 2018. The collected data included: patients' basic demographics and Comprehensive Geriatric Assessment (CGA) before treatment, chemotherapy-related adverse outcomes, unexpected hospitalizations, and emergency department visits within 3 months of treatment. We investigated the association between frailty and chemotherapy-related adverse outcomes in geriatric patients with cancer using the chi-square test and logistic regression analysis.

Results: The prevalence of frailty in geriatric patients with cancer was 58.1%. Age, marital status, main caregiver, cancer type, and Eastern Cooperative Oncology Group performance status, and physical fitness were factors associated with frailty. Frail geriatric patients with cancer were at higher risk of chemotherapy-related adverse outcomes, such as grades 3-4 thrombocytopenia (odds ratio [OR] = 11.13, p = 0.021) and grades 3-4 hyponatremia (OR = 12.03, p = 0.017), than non-frail patients, and they were at increased risk of unexpected hospitalizations (OR = 2.15, p = 0.025) and emergency department visits (OR = 1.99, p = 0.039).

Conclusions: Frailty is a common problem in geriatric patients with cancer and significantly impacts chemotherapy-related adverse outcomes. Our findings suggest that geriatric patients with cancer should undergo frail assessment prior to chemotherapy as a reference to guide future treatment decisions.

Keywords: chemotherapy-related adverse outcomes; comprehensive geriatric assessment; frailty; geriatric patients with cancer.

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Conflict of interest statement

CONFLICTS OF INTEREST: The authors declare no conflicts of interest related to this study.

Figures

Figure 1
Figure 1
Correlation between number of deficient frailty dimensions and grades 3–4 thrombocytopenia.
Figure 2
Figure 2
Correlation between number of deficient frailty dimensions and grade 3–4 hyponatremia.
See this image and copyright information in PMC

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