Prediction of hospital admissions and grade 3–4 toxicities in cancer patients 70 years old and older receiving chemotherapy. (20th August 2019)

• Record Type: Journal Article
• Authors: Reed, Melissa; Patrick, Caitlyn; Quevillon, Travis; Walde, Natalie; Voutsadakis, Ioannis A.
• Is Part Of: European journal of cancer care. Volume 28:Number 6(2019)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2019-08-20
• Subjects: cancer -- chemotherapy -- dose reduction -- geriatric -- hospital admissions -- prediction -- toxicity; Cancer -- Nursing -- Periodicals; 616.994
• DOI: 10.1111/ecc.13144
• Languages: English
• ISSNs: 0961-5423

Abstract

Abstract: Aim: To predict chemotherapy toxicity and hospitalisations in elderly patients using clinical and laboratory parameters. Methods: Records of cancer patients 70 years old or older who received adjuvant chemotherapy or first‐line chemotherapy for a cancer in a single centre were reviewed. Factors associated with hospitalisations, grade 3–4 toxicities and dose reductions during treatment were evaluated. Results: A total of 275 patients included in the study. Most patients (53.8%) were 70 to 75 years old. One hundred and five patients (38.2%) had a hospital admission during or within a month after their chemotherapy treatment. The only factor associated with admissions in the multivariate analysis was ECOG performance status (PS) >1 ( p = .008, odds ratio 2.66, 95% CI: 1.28–5.53) and hypoalbuminaemia approached significance. Grade 3 and 4 toxicities were associated with a lower creatinine clearance in the multivariate analysis ( p = .01, odds ratio 0.98, 95% CI: 0.97–1.0), and dose reductions were associated with metastatic stage ( p = .03, odds ratio 1.88, 95% CI: 1.05–3.35). A combined index with all four parameters was associated with all three outcomes of interest. Conclusion: ECOG PS, stage, albumin and creatinine clearance may be predictive of hospital admissions, grade 3–4 toxicities and dose reduction rates in cancer patients 70 years old and older receiving chemotherapy.