Prediction of chemotherapy adverse reactions and mortality in older patients with primary lung cancer through frailty index based on routine laboratory data
Yuting Wang,*,1 Rui Zhang*,2 Yanjiao Shen,1,3 Lin Su,1 Birong Dong,1 Qiukui Hao11The Center of Gerontology and Geriatrics/National Center for Geriatric Clinical Research, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; 2Health Informatics Cen...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2019-07-01
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| Series: | Clinical Interventions in Aging |
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| Online Access: | https://www.dovepress.com/prediction-of-chemotherapy-adverse-reactions-and-mortality-in-older-pa-peer-reviewed-article-CIA |
| _version_ | 1819195506622988288 |
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| author | Wang Y Zhang R Shen Y Su L Dong B Hao Q |
| author_facet | Wang Y Zhang R Shen Y Su L Dong B Hao Q |
| author_sort | Wang Y |
| collection | DOAJ |
| description | Yuting Wang,*,1 Rui Zhang*,2 Yanjiao Shen,1,3 Lin Su,1 Birong Dong,1 Qiukui Hao11The Center of Gerontology and Geriatrics/National Center for Geriatric Clinical Research, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; 2Health Informatics Center, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; 3Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu, People’s Republic of China*These authors contributed equally to this workObjectives: To assess the role of a pre-chemotherapy frailty index based on routine laboratory data in predicting mortality and chemotherapy adverse reactions among older patients with primary lung cancer.Design: Retrospective cohort studySetting: West China Hospital, Chengdu, ChinaParticipants: We included patients aged ≥60 years with primary lung cancer receiving the first course of chemotherapy.Measurements: Data were collected from medical records, local government death databases or telephone interviews. Outcomes included chemotherapy adverse reactions and all-cause mortality. We constructed a frailty index based on 44 laboratory variables (FI-LAB) before chemotherapy, and chose the following cutoff points: robust (0.0–0.2), pre-frail (0.2–0.35) and frail (≥0.35).Results: We included 1,020 patients (71.4% male; median age: 65 years old). Both pre-frailty and frailty was associated with any chemotherapy adverse reactions and infections during chemotherapy (OR=3.48, 95%CI: 1.77–6.87; OR=3.58, 95%CI: 1.55–8.26, respectively). Frail patients had a shorter median overall survival rate compared to robust patients (18.05 months vs 38.89 months, log-rank p<0.001). After adjusting for some potential confounding variables, the risk of all-cause mortality was dramatically increased in frail patients (HR:2.13, 95% CI:1.51–3.00) with an average follow-up of 3.9 years. Each 0.01 or per standard deviation (SD) increase in the FI-LAB value significantly increased the HR of death by 2.0% (HR:1.02, 95% CI: 1.01–1.03) and 23.0% (HR: 1.23, 95% CI: 1.13–1.34), respectively.Conclusions: Frailty assessed by routine laboratory data indicates increased risks of chemotherapy adverse reactions and death in older patients with primary lung cancer receiving the first course of chemotherapy.Keywords: frailty, prognosis, older patients, lung cancer, chemotherapy |
| first_indexed | 2024-12-23T02:13:51Z |
| format | Article |
| id | doaj.art-6afd57f7f8d44f10973bf55c5039cfc9 |
| institution | Directory Open Access Journal |
| issn | 1178-1998 |
| language | English |
| last_indexed | 2024-12-23T02:13:51Z |
| publishDate | 2019-07-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Interventions in Aging |
| spelling | doaj.art-6afd57f7f8d44f10973bf55c5039cfc92022-12-21T18:03:43ZengDove Medical PressClinical Interventions in Aging1178-19982019-07-01Volume 141187119746882Prediction of chemotherapy adverse reactions and mortality in older patients with primary lung cancer through frailty index based on routine laboratory dataWang YZhang RShen YSu LDong BHao QYuting Wang,*,1 Rui Zhang*,2 Yanjiao Shen,1,3 Lin Su,1 Birong Dong,1 Qiukui Hao11The Center of Gerontology and Geriatrics/National Center for Geriatric Clinical Research, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; 2Health Informatics Center, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; 3Sleep Medicine Center, West China Hospital, Sichuan University, Chengdu, People’s Republic of China*These authors contributed equally to this workObjectives: To assess the role of a pre-chemotherapy frailty index based on routine laboratory data in predicting mortality and chemotherapy adverse reactions among older patients with primary lung cancer.Design: Retrospective cohort studySetting: West China Hospital, Chengdu, ChinaParticipants: We included patients aged ≥60 years with primary lung cancer receiving the first course of chemotherapy.Measurements: Data were collected from medical records, local government death databases or telephone interviews. Outcomes included chemotherapy adverse reactions and all-cause mortality. We constructed a frailty index based on 44 laboratory variables (FI-LAB) before chemotherapy, and chose the following cutoff points: robust (0.0–0.2), pre-frail (0.2–0.35) and frail (≥0.35).Results: We included 1,020 patients (71.4% male; median age: 65 years old). Both pre-frailty and frailty was associated with any chemotherapy adverse reactions and infections during chemotherapy (OR=3.48, 95%CI: 1.77–6.87; OR=3.58, 95%CI: 1.55–8.26, respectively). Frail patients had a shorter median overall survival rate compared to robust patients (18.05 months vs 38.89 months, log-rank p<0.001). After adjusting for some potential confounding variables, the risk of all-cause mortality was dramatically increased in frail patients (HR:2.13, 95% CI:1.51–3.00) with an average follow-up of 3.9 years. Each 0.01 or per standard deviation (SD) increase in the FI-LAB value significantly increased the HR of death by 2.0% (HR:1.02, 95% CI: 1.01–1.03) and 23.0% (HR: 1.23, 95% CI: 1.13–1.34), respectively.Conclusions: Frailty assessed by routine laboratory data indicates increased risks of chemotherapy adverse reactions and death in older patients with primary lung cancer receiving the first course of chemotherapy.Keywords: frailty, prognosis, older patients, lung cancer, chemotherapyhttps://www.dovepress.com/prediction-of-chemotherapy-adverse-reactions-and-mortality-in-older-pa-peer-reviewed-article-CIAfrailtyprognosisolder patientslung cancerchemotherapy. |
| spellingShingle | Wang Y Zhang R Shen Y Su L Dong B Hao Q Prediction of chemotherapy adverse reactions and mortality in older patients with primary lung cancer through frailty index based on routine laboratory data Clinical Interventions in Aging frailty prognosis older patients lung cancer chemotherapy. |
| title | Prediction of chemotherapy adverse reactions and mortality in older patients with primary lung cancer through frailty index based on routine laboratory data |
| title_full | Prediction of chemotherapy adverse reactions and mortality in older patients with primary lung cancer through frailty index based on routine laboratory data |
| title_fullStr | Prediction of chemotherapy adverse reactions and mortality in older patients with primary lung cancer through frailty index based on routine laboratory data |
| title_full_unstemmed | Prediction of chemotherapy adverse reactions and mortality in older patients with primary lung cancer through frailty index based on routine laboratory data |
| title_short | Prediction of chemotherapy adverse reactions and mortality in older patients with primary lung cancer through frailty index based on routine laboratory data |
| title_sort | prediction of chemotherapy adverse reactions and mortality in older patients with primary lung cancer through frailty index based on routine laboratory data |
| topic | frailty prognosis older patients lung cancer chemotherapy. |
| url | https://www.dovepress.com/prediction-of-chemotherapy-adverse-reactions-and-mortality-in-older-pa-peer-reviewed-article-CIA |
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