Geriatric functional assessment for decision-making on adjuvant chemotherapy in older colon cancer patients
Background/Aims Despite the increasing need for geriatric assessment prior to chemotherapy, the method for this assessment remains inadequate for older cancer patients. We aimed to propose a simple assessment method to predict the performance of adjuvant chemotherapy in older patients after colon ca...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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The Korean Association of Internal Medicine
2022-05-01
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| Series: | The Korean Journal of Internal Medicine |
| Subjects: | |
| Online Access: | http://www.kjim.org/upload/pdf/kjim-2021-324.pdf |
| _version_ | 1828776694481158144 |
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| author | Hyun Jin Bang Hyun Jeong Shim Ga Ram Kim Jun Eul Hwang Woo Kyun Bae Ik Joo Chung Sang Hee Cho |
| author_facet | Hyun Jin Bang Hyun Jeong Shim Ga Ram Kim Jun Eul Hwang Woo Kyun Bae Ik Joo Chung Sang Hee Cho |
| author_sort | Hyun Jin Bang |
| collection | DOAJ |
| description | Background/Aims Despite the increasing need for geriatric assessment prior to chemotherapy, the method for this assessment remains inadequate for older cancer patients. We aimed to propose a simple assessment method to predict the performance of adjuvant chemotherapy in older patients after colon cancer surgery. Methods This prospective study included patients over 65 years of age who were scheduled for adjuvant chemotherapy after colon cancer surgery. Before initiating chemotherapy, their functional status was assessed on the basis of activities of daily living (ADL)/instrumental activities of daily living (IADL). These parameters were analyzed with clinical characteristics and the patterns of adjuvant chemotherapy. The focus was on the completion rate of adjuvant chemotherapy. Results A total of 89 patients with a median age of 72 years were analyzed. Among them, 54 (61%) were non-impaired and 35 (39%) were impaired regarding their ADL/IADL classification. Low body mass index and impairment of ADL/IADLs were significantly associated with chemotherapy interruption. Among toxicities, fatigue and hand-foot syndrome were independent prognostic factors for chemotherapy interruption. Impairments of ADL/IADL were significantly associated with fatigue regardless of age. Based on age and ADL/IADL stratification, younger patients (≤ 72 years) and/or those who were ADL/IADL non-impaired were significantly more likely to complete adjuvant chemotherapy than older patients (> 72 years) and ADL/IADL impaired patients (p = 0.038). This was regardless of the chemotherapy regimen. Conclusions Functional assessment using ADL/IADL is a convenient method to predict chemotherapy toxicity and performance. These results suggested that routine screening for ADL/IADLs could guide appropriate patient selection for the completion of adjuvant chemotherapy and predict expected outcomes. |
| first_indexed | 2024-12-11T16:04:29Z |
| format | Article |
| id | doaj.art-2b33796ff14b43379fb045a61229546f |
| institution | Directory Open Access Journal |
| issn | 1226-3303 2005-6648 |
| language | English |
| last_indexed | 2024-12-11T16:04:29Z |
| publishDate | 2022-05-01 |
| publisher | The Korean Association of Internal Medicine |
| record_format | Article |
| series | The Korean Journal of Internal Medicine |
| spelling | doaj.art-2b33796ff14b43379fb045a61229546f2022-12-22T00:59:13ZengThe Korean Association of Internal MedicineThe Korean Journal of Internal Medicine1226-33032005-66482022-05-0137366067210.3904/kjim.2021.324170672Geriatric functional assessment for decision-making on adjuvant chemotherapy in older colon cancer patientsHyun Jin BangHyun Jeong ShimGa Ram KimJun Eul HwangWoo Kyun BaeIk Joo ChungSang Hee ChoBackground/Aims Despite the increasing need for geriatric assessment prior to chemotherapy, the method for this assessment remains inadequate for older cancer patients. We aimed to propose a simple assessment method to predict the performance of adjuvant chemotherapy in older patients after colon cancer surgery. Methods This prospective study included patients over 65 years of age who were scheduled for adjuvant chemotherapy after colon cancer surgery. Before initiating chemotherapy, their functional status was assessed on the basis of activities of daily living (ADL)/instrumental activities of daily living (IADL). These parameters were analyzed with clinical characteristics and the patterns of adjuvant chemotherapy. The focus was on the completion rate of adjuvant chemotherapy. Results A total of 89 patients with a median age of 72 years were analyzed. Among them, 54 (61%) were non-impaired and 35 (39%) were impaired regarding their ADL/IADL classification. Low body mass index and impairment of ADL/IADLs were significantly associated with chemotherapy interruption. Among toxicities, fatigue and hand-foot syndrome were independent prognostic factors for chemotherapy interruption. Impairments of ADL/IADL were significantly associated with fatigue regardless of age. Based on age and ADL/IADL stratification, younger patients (≤ 72 years) and/or those who were ADL/IADL non-impaired were significantly more likely to complete adjuvant chemotherapy than older patients (> 72 years) and ADL/IADL impaired patients (p = 0.038). This was regardless of the chemotherapy regimen. Conclusions Functional assessment using ADL/IADL is a convenient method to predict chemotherapy toxicity and performance. These results suggested that routine screening for ADL/IADLs could guide appropriate patient selection for the completion of adjuvant chemotherapy and predict expected outcomes.http://www.kjim.org/upload/pdf/kjim-2021-324.pdfgeriatric assessmentdrug therapyadjuvantcolonic neoplasms |
| spellingShingle | Hyun Jin Bang Hyun Jeong Shim Ga Ram Kim Jun Eul Hwang Woo Kyun Bae Ik Joo Chung Sang Hee Cho Geriatric functional assessment for decision-making on adjuvant chemotherapy in older colon cancer patients The Korean Journal of Internal Medicine geriatric assessment drug therapy adjuvant colonic neoplasms |
| title | Geriatric functional assessment for decision-making on adjuvant chemotherapy in older colon cancer patients |
| title_full | Geriatric functional assessment for decision-making on adjuvant chemotherapy in older colon cancer patients |
| title_fullStr | Geriatric functional assessment for decision-making on adjuvant chemotherapy in older colon cancer patients |
| title_full_unstemmed | Geriatric functional assessment for decision-making on adjuvant chemotherapy in older colon cancer patients |
| title_short | Geriatric functional assessment for decision-making on adjuvant chemotherapy in older colon cancer patients |
| title_sort | geriatric functional assessment for decision making on adjuvant chemotherapy in older colon cancer patients |
| topic | geriatric assessment drug therapy adjuvant colonic neoplasms |
| url | http://www.kjim.org/upload/pdf/kjim-2021-324.pdf |
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