Association of frailty with chemotherapy toxicity in chemotherapy-naive older patients with cancer.

Abstract

The purpose of this study is to assess the relationship between chemotherapy toxicity and frailty as determined using the Edmonton Frail Scale (EFS). Older adults (≥ 65years old) newly diagnosed with cancer were evaluated for frailty with EFS prior to chemotherapy. Participants evaluated on 17 points were grouped as "No Frailty" (0-4), "Apparently Vulnerable" (5-6), "Mild Frailty" (7-8), "Moderate Frailty" (9-10), and "Severe Frailty" (11 or more). Before the second and third chemotherapy cycles, patients were reassessed for toxicity. Of the 44 participants, 12 (27.4%) were rated as "frail" (EFS score ≥ 7). The median Charlson Age-Comorbidity Index score was 3 (IQR: 1), and the median EFS score was 5 (IQR: 3). There was no significant difference between the "frail" and "robust" groups in terms of the toxicity. There was no correlation between age, gender, chemotherapy intent, chemotherapy dosing, ECOG performance score, or other parameters with grade 3 or higher toxicity development. The Edmonton Frail Scale is not successful in predicting the toxicity risk of chemotherapy. However, it may be used as a tool to determine the need for comprehensive geriatric assessment and it may lead to increased alertness to adverse events during treatment of frail patients.