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Geriatric assessment may help decision-making in elderly patients with inoperable, locally advanced non-small-cell lung cancer
Background: although concurrent chemoradiotherapy (cCRT) increases survival in patients with inoperable, locally advanced non-small-cell lung cancer (NSCLC), there is no consensus on the treatment of elderly patients. The aim of this study was to determine the prognostic value of the comprehensive g...
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| Published in: | British journal of cancer 2018-03 |
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| creator | Antonio, Maite Saldaña, Juana Linares, Jennifer Ruffinelli, José C Palmero, Ramon Navarro Martin, Arturo Arnaiz, Maria Dolores Brao, Isabel Aso, Samantha Padrones, Susana Navarro-Pérez, Valentin González Barboteo, Jesús Borràs Andrés, Josep Maria Cardenal Alemany, Felipe Nadal, Ernest |
| description | Background: although concurrent chemoradiotherapy (cCRT) increases survival in patients with inoperable, locally advanced non-small-cell lung cancer (NSCLC), there is no consensus on the treatment of elderly patients. The aim of this study was to determine the prognostic value of the comprehensive geriatric assessment (CGA) and its ability to predict toxicity in this setting. Methods: we enrolled 85 consecutive elderly (⩾75 years) participants, who underwent CGA and the Vulnerable Elders Survey (VES-13). Those classified as fit and medium-fit by CGA were deemed candidates for cCRT (platinum-based chemotherapy concurrent with thoracic radiation therapy), while unfit patients received best supportive care. Results: fit (37%) and medium-fit (48%) patients had significantly longer median overall survival (mOS) (23.9 and 16.9 months, respectively) than unfit patients (15%) (9.3 months, log-rank P=0.01). In multivariate analysis, CGA groups and VES-13 were independent prognostic factors. Fit and medium-fit patients receiving cCRT (n=54) had mOS of 21.1 months (95% confidence interval: 16.2, 26.0). In those patients, higher VES-13 (⩾3) was associated with shorter mOS (16.33 vs 24.3 months, P=0.027) and higher risk of G3-4 toxicity (65 vs 32%, P=0.028). Conclusions: comprehensive geriatric assessment and VES-13 showed independent prognostic value. Comprehensive geriatric assessment may help to identify elderly patients fit enough to be treated with cCRT. |
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| fullrecord | <record><control><sourceid>csuc</sourceid><recordid>TN_cdi_csuc_recercat_oai_recercat_cat_2072_369815</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>oai_recercat_cat_2072_369815</sourcerecordid><originalsourceid>FETCH-csuc_recercat_oai_recercat_cat_2072_3698153</originalsourceid><addsrcrecordid>eNqdjM1uwkAMhPcAUoHyDn6ARlqCSsi56s8DcI9cx4DB2UTrDVUuffYuUqXeexhZ4_lmZm7hva8KX5f-wS3NLtnWfl8t3Pc7R8EUhQDN2KzjkKDDCc6sA7RMYtKHosOrhBNIANaWo04wYJLMGnxJOuegHzjip_ITaE-omcD2hoG4hZAHrMu_glgVdMxLdI_io5sfUY3Xv3flNm-vh5ePgmykJnJGCFPTo_yZu0pflc12V-83z9v_dH4ADv5asA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Geriatric assessment may help decision-making in elderly patients with inoperable, locally advanced non-small-cell lung cancer</title><source>PubMed (Medline)</source><creator>Antonio, Maite ; Saldaña, Juana ; Linares, Jennifer ; Ruffinelli, José C ; Palmero, Ramon ; Navarro Martin, Arturo ; Arnaiz, Maria Dolores ; Brao, Isabel ; Aso, Samantha ; Padrones, Susana ; Navarro-Pérez, Valentin ; González Barboteo, Jesús ; Borràs Andrés, Josep Maria ; Cardenal Alemany, Felipe ; Nadal, Ernest</creator><creatorcontrib>Antonio, Maite ; Saldaña, Juana ; Linares, Jennifer ; Ruffinelli, José C ; Palmero, Ramon ; Navarro Martin, Arturo ; Arnaiz, Maria Dolores ; Brao, Isabel ; Aso, Samantha ; Padrones, Susana ; Navarro-Pérez, Valentin ; González Barboteo, Jesús ; Borràs Andrés, Josep Maria ; Cardenal Alemany, Felipe ; Nadal, Ernest</creatorcontrib><description>Background: although concurrent chemoradiotherapy (cCRT) increases survival in patients with inoperable, locally advanced non-small-cell lung cancer (NSCLC), there is no consensus on the treatment of elderly patients. The aim of this study was to determine the prognostic value of the comprehensive geriatric assessment (CGA) and its ability to predict toxicity in this setting. Methods: we enrolled 85 consecutive elderly (⩾75 years) participants, who underwent CGA and the Vulnerable Elders Survey (VES-13). Those classified as fit and medium-fit by CGA were deemed candidates for cCRT (platinum-based chemotherapy concurrent with thoracic radiation therapy), while unfit patients received best supportive care. Results: fit (37%) and medium-fit (48%) patients had significantly longer median overall survival (mOS) (23.9 and 16.9 months, respectively) than unfit patients (15%) (9.3 months, log-rank P=0.01). In multivariate analysis, CGA groups and VES-13 were independent prognostic factors. Fit and medium-fit patients receiving cCRT (n=54) had mOS of 21.1 months (95% confidence interval: 16.2, 26.0). In those patients, higher VES-13 (⩾3) was associated with shorter mOS (16.33 vs 24.3 months, P=0.027) and higher risk of G3-4 toxicity (65 vs 32%, P=0.028). Conclusions: comprehensive geriatric assessment and VES-13 showed independent prognostic value. Comprehensive geriatric assessment may help to identify elderly patients fit enough to be treated with cCRT.</description><identifier>ISSN: 0007-0920</identifier><language>eng</language><publisher>Cancer Research UK</publisher><subject>Càncer de pulmó ; Geriatria ; Geriatrics ; Lung cancer ; Palliative treatment ; Tractament pal·liatiu</subject><ispartof>British journal of cancer, 2018-03</ispartof><rights>cc by-nc-sa (c) Antonio, Maite et al., 2018 info:eu-repo/semantics/openAccess <a href="http://creativecommons.org/licenses/by-nc-sa/3.0/es/">http://creativecommons.org/licenses/by-nc-sa/3.0/es/</a></rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,315,786,790,891</link.rule.ids></links><search><creatorcontrib>Antonio, Maite</creatorcontrib><creatorcontrib>Saldaña, Juana</creatorcontrib><creatorcontrib>Linares, Jennifer</creatorcontrib><creatorcontrib>Ruffinelli, José C</creatorcontrib><creatorcontrib>Palmero, Ramon</creatorcontrib><creatorcontrib>Navarro Martin, Arturo</creatorcontrib><creatorcontrib>Arnaiz, Maria Dolores</creatorcontrib><creatorcontrib>Brao, Isabel</creatorcontrib><creatorcontrib>Aso, Samantha</creatorcontrib><creatorcontrib>Padrones, Susana</creatorcontrib><creatorcontrib>Navarro-Pérez, Valentin</creatorcontrib><creatorcontrib>González Barboteo, Jesús</creatorcontrib><creatorcontrib>Borràs Andrés, Josep Maria</creatorcontrib><creatorcontrib>Cardenal Alemany, Felipe</creatorcontrib><creatorcontrib>Nadal, Ernest</creatorcontrib><title>Geriatric assessment may help decision-making in elderly patients with inoperable, locally advanced non-small-cell lung cancer</title><title>British journal of cancer</title><description>Background: although concurrent chemoradiotherapy (cCRT) increases survival in patients with inoperable, locally advanced non-small-cell lung cancer (NSCLC), there is no consensus on the treatment of elderly patients. The aim of this study was to determine the prognostic value of the comprehensive geriatric assessment (CGA) and its ability to predict toxicity in this setting. Methods: we enrolled 85 consecutive elderly (⩾75 years) participants, who underwent CGA and the Vulnerable Elders Survey (VES-13). Those classified as fit and medium-fit by CGA were deemed candidates for cCRT (platinum-based chemotherapy concurrent with thoracic radiation therapy), while unfit patients received best supportive care. Results: fit (37%) and medium-fit (48%) patients had significantly longer median overall survival (mOS) (23.9 and 16.9 months, respectively) than unfit patients (15%) (9.3 months, log-rank P=0.01). In multivariate analysis, CGA groups and VES-13 were independent prognostic factors. Fit and medium-fit patients receiving cCRT (n=54) had mOS of 21.1 months (95% confidence interval: 16.2, 26.0). In those patients, higher VES-13 (⩾3) was associated with shorter mOS (16.33 vs 24.3 months, P=0.027) and higher risk of G3-4 toxicity (65 vs 32%, P=0.028). Conclusions: comprehensive geriatric assessment and VES-13 showed independent prognostic value. Comprehensive geriatric assessment may help to identify elderly patients fit enough to be treated with cCRT.</description><subject>Càncer de pulmó</subject><subject>Geriatria</subject><subject>Geriatrics</subject><subject>Lung cancer</subject><subject>Palliative treatment</subject><subject>Tractament pal·liatiu</subject><issn>0007-0920</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNqdjM1uwkAMhPcAUoHyDn6ARlqCSsi56s8DcI9cx4DB2UTrDVUuffYuUqXeexhZ4_lmZm7hva8KX5f-wS3NLtnWfl8t3Pc7R8EUhQDN2KzjkKDDCc6sA7RMYtKHosOrhBNIANaWo04wYJLMGnxJOuegHzjip_ITaE-omcD2hoG4hZAHrMu_glgVdMxLdI_io5sfUY3Xv3flNm-vh5ePgmykJnJGCFPTo_yZu0pflc12V-83z9v_dH4ADv5asA</recordid><startdate>20180306</startdate><enddate>20180306</enddate><creator>Antonio, Maite</creator><creator>Saldaña, Juana</creator><creator>Linares, Jennifer</creator><creator>Ruffinelli, José C</creator><creator>Palmero, Ramon</creator><creator>Navarro Martin, Arturo</creator><creator>Arnaiz, Maria Dolores</creator><creator>Brao, Isabel</creator><creator>Aso, Samantha</creator><creator>Padrones, Susana</creator><creator>Navarro-Pérez, Valentin</creator><creator>González Barboteo, Jesús</creator><creator>Borràs Andrés, Josep Maria</creator><creator>Cardenal Alemany, Felipe</creator><creator>Nadal, Ernest</creator><general>Cancer Research UK</general><scope>XX2</scope></search><sort><creationdate>20180306</creationdate><title>Geriatric assessment may help decision-making in elderly patients with inoperable, locally advanced non-small-cell lung cancer</title><author>Antonio, Maite ; Saldaña, Juana ; Linares, Jennifer ; Ruffinelli, José C ; Palmero, Ramon ; Navarro Martin, Arturo ; Arnaiz, Maria Dolores ; Brao, Isabel ; Aso, Samantha ; Padrones, Susana ; Navarro-Pérez, Valentin ; González Barboteo, Jesús ; Borràs Andrés, Josep Maria ; Cardenal Alemany, Felipe ; Nadal, Ernest</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-csuc_recercat_oai_recercat_cat_2072_3698153</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Càncer de pulmó</topic><topic>Geriatria</topic><topic>Geriatrics</topic><topic>Lung cancer</topic><topic>Palliative treatment</topic><topic>Tractament pal·liatiu</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Antonio, Maite</creatorcontrib><creatorcontrib>Saldaña, Juana</creatorcontrib><creatorcontrib>Linares, Jennifer</creatorcontrib><creatorcontrib>Ruffinelli, José C</creatorcontrib><creatorcontrib>Palmero, Ramon</creatorcontrib><creatorcontrib>Navarro Martin, Arturo</creatorcontrib><creatorcontrib>Arnaiz, Maria Dolores</creatorcontrib><creatorcontrib>Brao, Isabel</creatorcontrib><creatorcontrib>Aso, Samantha</creatorcontrib><creatorcontrib>Padrones, Susana</creatorcontrib><creatorcontrib>Navarro-Pérez, Valentin</creatorcontrib><creatorcontrib>González Barboteo, Jesús</creatorcontrib><creatorcontrib>Borràs Andrés, Josep Maria</creatorcontrib><creatorcontrib>Cardenal Alemany, Felipe</creatorcontrib><creatorcontrib>Nadal, Ernest</creatorcontrib><collection>Recercat</collection><jtitle>British journal of cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Antonio, Maite</au><au>Saldaña, Juana</au><au>Linares, Jennifer</au><au>Ruffinelli, José C</au><au>Palmero, Ramon</au><au>Navarro Martin, Arturo</au><au>Arnaiz, Maria Dolores</au><au>Brao, Isabel</au><au>Aso, Samantha</au><au>Padrones, Susana</au><au>Navarro-Pérez, Valentin</au><au>González Barboteo, Jesús</au><au>Borràs Andrés, Josep Maria</au><au>Cardenal Alemany, Felipe</au><au>Nadal, Ernest</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Geriatric assessment may help decision-making in elderly patients with inoperable, locally advanced non-small-cell lung cancer</atitle><jtitle>British journal of cancer</jtitle><date>2018-03-06</date><risdate>2018</risdate><issn>0007-0920</issn><abstract>Background: although concurrent chemoradiotherapy (cCRT) increases survival in patients with inoperable, locally advanced non-small-cell lung cancer (NSCLC), there is no consensus on the treatment of elderly patients. The aim of this study was to determine the prognostic value of the comprehensive geriatric assessment (CGA) and its ability to predict toxicity in this setting. Methods: we enrolled 85 consecutive elderly (⩾75 years) participants, who underwent CGA and the Vulnerable Elders Survey (VES-13). Those classified as fit and medium-fit by CGA were deemed candidates for cCRT (platinum-based chemotherapy concurrent with thoracic radiation therapy), while unfit patients received best supportive care. Results: fit (37%) and medium-fit (48%) patients had significantly longer median overall survival (mOS) (23.9 and 16.9 months, respectively) than unfit patients (15%) (9.3 months, log-rank P=0.01). In multivariate analysis, CGA groups and VES-13 were independent prognostic factors. Fit and medium-fit patients receiving cCRT (n=54) had mOS of 21.1 months (95% confidence interval: 16.2, 26.0). In those patients, higher VES-13 (⩾3) was associated with shorter mOS (16.33 vs 24.3 months, P=0.027) and higher risk of G3-4 toxicity (65 vs 32%, P=0.028). Conclusions: comprehensive geriatric assessment and VES-13 showed independent prognostic value. Comprehensive geriatric assessment may help to identify elderly patients fit enough to be treated with cCRT.</abstract><pub>Cancer Research UK</pub><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Càncer de pulmó Geriatria Geriatrics Lung cancer Palliative treatment Tractament pal·liatiu |
| title | Geriatric assessment may help decision-making in elderly patients with inoperable, locally advanced non-small-cell lung cancer |
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