658 - Use of Comprehensive Geriatric Assessment Parameters to Predict Chemotherapy Toxicity in Elderly Patients with Colorectal Cancer: a Prospective Mono-Center Study

Abstract

ABSTRACT Background Despite the younger age of Algerian population, Colorectal cancer that represent the second most common malignancy, occurred in Older patients (age ≥ 65 y) in approximately one quarter of cases . Unfortunately, there is little studies including these geriatric population. Purpose The aim of this study is to identify parameters of Comprehensive Geriatric Assessment “CGA“ that may represent risk factors for chemotherapy toxicity in older adults with colorectal cancer than to develop a predicting risk scoring for chemotherapy toxicity. Patients and methods A prospective study in our department collected on 2 years 66 patients age 65 years or older . Application of oncologic data and geriatric assessment variables (function, comorbidity, cognition, psychological state, social activity/support, and nutritional status) selected 49 patients illegible for chemotherapy. Mean age: 71 y (range 65-81 y), gender: 27 women, 22 men. Localization: colon: 36pts/ rectum: 12pts/multifocal: 1pt. Balducci 1: 13 pts / Balducci 2 : 36 pts. All patients were evaluated for grade ¾ chemo-toxicity as defined by the version 4.0 of National Cancer Institute Common Terminology Criteria for Adverse Events. Results After a total of 394 courses, 34 pts presents Grade ¾ toxicity. It occurred in 25,5% of cures and included neuropathy: 5%, diarrhea 5,6%, hand-foot syndrome 2,8%, neutropenia 0,8%, thrombocytopenia 0,8%, Anemia 6% . According to univariate and multivariate analyses: age (≤ or ˃ 70 y), Balducci groups, anemia and number of drugs used (mono vs poly-chemotherapy) were identified to be risk factors significantly associated with chemo-toxicity (p˂0,05, IC95). A simple predictive model for grade ¾ chemo-toxicity was developed using regression coefficients from the multivariate model.The scoring system (range 0 to 13) stratification schema 3 groups : pts at low (0 to 3 points), intermediate (4 to 7 points), or high risk (8 to 13 points) of chemotherapy toxicity (p = 0,0112). Conclusions Results of our study suggest that the incorporation of a mini- CGA in our daily practice can help physicians to establish a personalized therapeutic decision for elderly colorectal cancers based on chemo-toxicity risk stratification. Disclosure All authors have declared no conflicts of interest.