Correlation of an Electronic Geriatric Assessment With Receipt of Adjuvant Radiation and Chemotherapy in Older Adults With Head and Neck Cancer
Purpose: Treatment patterns for head and neck squamous cell carcinoma (HNSCC) vary among older adults because of concerns about their health status. Geriatric assessment may guide treatment for older adults with HNSCC by assessing their health status. Methods and Materials: We conducted a retrospect...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Advances in Radiation Oncology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2452109422002020 |
| _version_ | 1798017167543762944 |
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| author | Daniel Restifo, MA Gabriel Raab, BA Sean M. McBride, MD, MPH David G. Pfister, MD Richard J. Wong, MD Nancy Y. Lee, MD Armin Shahrokni, MD, MPH Kaveh Zakeri, MD, MAS |
| author_facet | Daniel Restifo, MA Gabriel Raab, BA Sean M. McBride, MD, MPH David G. Pfister, MD Richard J. Wong, MD Nancy Y. Lee, MD Armin Shahrokni, MD, MPH Kaveh Zakeri, MD, MAS |
| author_sort | Daniel Restifo, MA |
| collection | DOAJ |
| description | Purpose: Treatment patterns for head and neck squamous cell carcinoma (HNSCC) vary among older adults because of concerns about their health status. Geriatric assessment may guide treatment for older adults with HNSCC by assessing their health status. Methods and Materials: We conducted a retrospective review of adjuvant treatment received by older patients with HNSCC who completed a novel geriatric assessment, the electronic Rapid Fitness Assessment, before treatment. The electronic Rapid Fitness Assessment yields an accumulated geriatric deficits (AGD) score. Higher AGD score indicates greater frailty. Comparators were age and performance status. The Wilcoxon rank sum test compared differences between those who did and did not receive adjuvant radiation therapy and chemotherapy. Results: The cohort included 73 patients, of whom 56 (77%) had oral cavity cancer. The most common geriatric deficits were major distress, social activity limitation, depression, and impaired activities of daily living. AGD score, age, and performance status were not associated with receipt of adjuvant radiation. Patients who received adjuvant chemotherapy had a significantly lower median AGD score than those who did not (3 vs 6; P = .044), but there was no association with age and performance status. Of the 17 patients with newly diagnosed disease and either positive margins or extranodal extension, only 9 received adjuvant radiation and only 3 received systemic therapy. Most often, systemic therapy was omitted because of patient preference or comorbidities and poor performance status. There was a nonstatistically significant lower AGD score between patients who did and did not receive standard fractionated radiation therapy (median, 4 vs 6.5; P = .13). Conclusions: Receipt of adjuvant chemotherapy was associated with frailty. Rates of chemotherapy utilization were very low, indicating the need for novel strategies to mitigate the toxicity burden in this patient population. Receipt of adjuvant radiation therapy was not associated with frailty; however, there was a trend toward lower frailty among those who did receive radiation therapy. |
| first_indexed | 2024-04-11T16:02:41Z |
| format | Article |
| id | doaj.art-672592fed3a24477a6a19fd9ae27b5d6 |
| institution | Directory Open Access Journal |
| issn | 2452-1094 |
| language | English |
| last_indexed | 2024-04-11T16:02:41Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Advances in Radiation Oncology |
| spelling | doaj.art-672592fed3a24477a6a19fd9ae27b5d62022-12-22T04:14:55ZengElsevierAdvances in Radiation Oncology2452-10942023-01-0181101096Correlation of an Electronic Geriatric Assessment With Receipt of Adjuvant Radiation and Chemotherapy in Older Adults With Head and Neck CancerDaniel Restifo, MA0Gabriel Raab, BA1Sean M. McBride, MD, MPH2David G. Pfister, MD3Richard J. Wong, MD4Nancy Y. Lee, MD5Armin Shahrokni, MD, MPH6Kaveh Zakeri, MD, MAS7Weill Cornell Medical College, New York, New YorkWeill Cornell Medical College, New York, New YorkDepartments of Radiation OncologyMedical OncologySurgery, Memorial Sloan Kettering Cancer Center, New York, New YorkDepartments of Radiation OncologyGeriatrics Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New YorkDepartments of Radiation Oncology; Corresponding author: Kaveh Zakeri, MD, MASPurpose: Treatment patterns for head and neck squamous cell carcinoma (HNSCC) vary among older adults because of concerns about their health status. Geriatric assessment may guide treatment for older adults with HNSCC by assessing their health status. Methods and Materials: We conducted a retrospective review of adjuvant treatment received by older patients with HNSCC who completed a novel geriatric assessment, the electronic Rapid Fitness Assessment, before treatment. The electronic Rapid Fitness Assessment yields an accumulated geriatric deficits (AGD) score. Higher AGD score indicates greater frailty. Comparators were age and performance status. The Wilcoxon rank sum test compared differences between those who did and did not receive adjuvant radiation therapy and chemotherapy. Results: The cohort included 73 patients, of whom 56 (77%) had oral cavity cancer. The most common geriatric deficits were major distress, social activity limitation, depression, and impaired activities of daily living. AGD score, age, and performance status were not associated with receipt of adjuvant radiation. Patients who received adjuvant chemotherapy had a significantly lower median AGD score than those who did not (3 vs 6; P = .044), but there was no association with age and performance status. Of the 17 patients with newly diagnosed disease and either positive margins or extranodal extension, only 9 received adjuvant radiation and only 3 received systemic therapy. Most often, systemic therapy was omitted because of patient preference or comorbidities and poor performance status. There was a nonstatistically significant lower AGD score between patients who did and did not receive standard fractionated radiation therapy (median, 4 vs 6.5; P = .13). Conclusions: Receipt of adjuvant chemotherapy was associated with frailty. Rates of chemotherapy utilization were very low, indicating the need for novel strategies to mitigate the toxicity burden in this patient population. Receipt of adjuvant radiation therapy was not associated with frailty; however, there was a trend toward lower frailty among those who did receive radiation therapy.http://www.sciencedirect.com/science/article/pii/S2452109422002020 |
| spellingShingle | Daniel Restifo, MA Gabriel Raab, BA Sean M. McBride, MD, MPH David G. Pfister, MD Richard J. Wong, MD Nancy Y. Lee, MD Armin Shahrokni, MD, MPH Kaveh Zakeri, MD, MAS Correlation of an Electronic Geriatric Assessment With Receipt of Adjuvant Radiation and Chemotherapy in Older Adults With Head and Neck Cancer Advances in Radiation Oncology |
| title | Correlation of an Electronic Geriatric Assessment With Receipt of Adjuvant Radiation and Chemotherapy in Older Adults With Head and Neck Cancer |
| title_full | Correlation of an Electronic Geriatric Assessment With Receipt of Adjuvant Radiation and Chemotherapy in Older Adults With Head and Neck Cancer |
| title_fullStr | Correlation of an Electronic Geriatric Assessment With Receipt of Adjuvant Radiation and Chemotherapy in Older Adults With Head and Neck Cancer |
| title_full_unstemmed | Correlation of an Electronic Geriatric Assessment With Receipt of Adjuvant Radiation and Chemotherapy in Older Adults With Head and Neck Cancer |
| title_short | Correlation of an Electronic Geriatric Assessment With Receipt of Adjuvant Radiation and Chemotherapy in Older Adults With Head and Neck Cancer |
| title_sort | correlation of an electronic geriatric assessment with receipt of adjuvant radiation and chemotherapy in older adults with head and neck cancer |
| url | http://www.sciencedirect.com/science/article/pii/S2452109422002020 |
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