Abstract

AimsTo investigate whether the Geriatric 8 (G8) score and the Timed Get Up and Go Test (TGUGT), together with clinical and demographic patient characteristics, are associated with survival and late toxicity after (chemo)radiation therapy, administered with curative intent in older patients with cancer. Materials and methodsFour hundred and two patients aged ≥65 years (median age 72 years, range 65–96 years), diagnosed with either breast, non-small cell lung, prostate, head and neck, rectal or oesophageal cancer, and referred for curative (chemo)radiation therapy, took part in a multicentre prospective cohort study in eight radiotherapy centres in the Netherlands. The G8 and TGUGT scores were assessed before starting treatment. Other potential predictors and late toxicity were also recorded. Survival status and date of death, if applicable, were ascertained at the Dutch national death registry. ResultsAfter 2.5 years, the overall survival was 83%. Survival was 87% for patients with high G8 scores and 55% for patients with low G8 scores (Log-rank P value < 0.0001). Survival was 77% for patients with good TGUGT results and 50% for patients with poor TGUGT results (Log-rank P value < 0.001). In multivariable analysis, in addition to age and type of primary tumour, the association of the G8 score with overall survival remained, with a hazard ratio of 2.1 (95% confidence interval 1.2–3.8) for low versus high scores. ConclusionsG8 was associated with overall survival in older patients with cancer irradiated with curative intent. This association was independent of the predictive value of age and primary tumour.

Highlights

  • Radiotherapy treatment guidelines are preferably based on evidence obtained from the results of clinical trials

  • We report the results of 2.5 years of follow-up for this cohort of older patients with cancer irradiated with curative intent, to investigate whether Geriatric 8 (G8), Timed Get Up and Go Test (TGUGT) and clinical and demographic patient characteristics were associated with serious late toxicity and overall survival

  • In older patients with cancer irradiated with curative intent, low G8 scores predicted for decreased overall survival

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Summary

Introduction

Radiotherapy treatment guidelines are preferably based on evidence obtained from the results of clinical trials. This could pose a problem for older patients with cancer, because they are underrepresented in clinical trials [1]. We know that older patients differ from younger patients because they experience comorbidities more often. They are at a higher risk of being frail. Frailty may have various dimensions and patients sensitive to one stressor may be less sensitive to another It remains unclear whether a general measure of frailty will accurately predict for outcomes after radiotherapy

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