Functional Decline in Older Patients With Cancer Receiving First-Line Chemotherapy

Hoppe, Stéphanie; Rainfray, Muriel; Fonck, Marianne; Hoppenreys, Laurent; Blanc, Jean‐Frédéric; Ceccaldi, J.; Mertens, C.; Blanc-Bisson, C.; Imbert, Y.; Cany, Laurent; Vogt, Luc; Dauba, Jérôme; Houédé, Nadine; Bellera, Carine; Floquet, Anne; Fabry, Marie-Noëlle; Ravaud, Alain; Chakiba, Camille; Mathoulin‐Pélissier, Simone; Soubeyran, Pierre

doi:10.1200/jco.2012.47.7430

Cited by 212 publications

(198 citation statements)

References 41 publications

(13 reference statements)

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“…Finally, 16 publications from 15 studies [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31], involving 4187 patients, were included in the analysis. Crossreferencing yielded no additional results.…”

Section: Search Outcomementioning

confidence: 99%

Physical performance measures for predicting outcome in cancer patients: a systematic review

et al. 2016

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Background: Decision making regarding cancer treatment is challenging and there is a need for clinical parameters that can guide these decisions. As physical performance appears to be a reflection of health status, the aim of this systematic review is to assess whether physical performance tests (PPTs) are predictive of the clinical outcome and treatment tolerance in cancer patients. Methods: A literature search was conducted on 2 April 2015 in the electronic databases Medline and Embase to identify studies focusing on the association between objectively measured PPTs and outcome. No limitations in language or publication dates were applied. Results: The search retrieved 9680 articles, 16 publications were included involving 4187 patients with various cancer types and different treatments. Reported median or mean age varied from 58 to 78 years. Nine studies used the Timed Up & Go (TUG) test, five the Short Physical Performance Battery (SPPB) and five studies focused on gait speed. Poorer TUG, SPPB and gait speed outcome were associated with decreased survival. TUG, SPPB and gait speed were also associated with treatment-related complications. Furthermore, two studies reported an association between poorer TUG and SPPB outcome with higher rates of functional decline. Conclusion: PPTs appear to show a significant correlation with survival and these tests could be used as a prognostic tool, particular for older adult patients. A less explicit correlation for treatment-related complications and functional decline was also found. To optimize decision making, future research should focus on developing and validating individualized treatment algorithms that incorporate PPTs in addition to cancer-and treatment-related variables.

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Section: Search Outcomementioning

confidence: 99%

Physical performance measures for predicting outcome in cancer patients: a systematic review

et al. 2016

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“…self-reported 15-item measure, is also predictive of an increased risk of functional decline. 75 Two geriatric assessment-based tools, the CARG chemotherapy toxicity calculator (shown in Appendix Table A2, online only 76 ) and the CRASH score, 76 can also be used by health care providers to understand the patient's toxicity risk and guide shared decision-making when starting a new line of treatment in an older patient. 78,79 These two calculators, which can be freely accessed online, use patient, tumor, and geriatric assessment information to predict the probability of experiencing grade $ 3 toxicities.…”

Section: Other Brief Measures and Geriatric Assessment-based Toolsmentioning

confidence: 99%

What Every Oncologist Should Know About Geriatric Assessment for Older Patients With Cancer: Young International Society of Geriatric Oncology Position Paper

Loh

Soto‐Pérez‐de‐Celis

Hsu

et al. 2018

JOP

134

105

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Aging is a heterogeneous process. Most newly diagnosed cancers occur in older adults, and it is important to understand a patient's underlying health status when making treatment decisions. A geriatric assessment provides a detailed evaluation of medical, psychosocial, and functional problems in older patients with cancer. Specifically, it can identify areas of vulnerability, predict survival and toxicity, assist in clinical treatment decisions, and guide interventions in routine oncology practice; however, the uptake is hampered by limitations in both time and resources, as well as by a lack of expert interpretation. In this review, we describe the utility of geriatric assessment by using an illustrative case and provide a practical approach to geriatric assessment in oncology. CASE J.K. is a 73-year-old man who presented to his primary care physician complaining of bright red blood per rectum. He has a medical history of coronary artery disease, hypertension, hyperlipidemia, and cerebrovascular disease. He is on aspirin, lisinopril, metoprolol, and atorvastatin. A subsequent colonoscopy revealed a 3-cm mass in his descending colon. Biopsy of the mass showed invasive adenocarcinoma. He underwent computed tomography scans of the chest, abdomen, and pelvis, which showed no evidence of metastases. A laparoscopic colectomy was performed, and his cancer was staged as T2N2 (stage III) and microsatellite stable. He is referred to you to discuss adjuvant chemotherapy.

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“…The proportion of patients with low grip strength was higher than that seen in the Cardiovascular Health Study (20%) 28 , and average gait speed was slower than speeds measured for community-dwelling older adults in all but one study in a large systematic review 18 . Compared with other studies of older cancer patients, our study had a larger proportion of patients with low grip strength (50% vs. 21.4%) 32 and a higher proportion with a gait speed less than 1.0 m/s (91.7% vs. 54.4%) 32 , but a smaller proportion with a prolonged time on the tug test 7,[33][34][35][36][37][38] . Because gait speed was not reported in the latter studies, it is difficult to know whether average gait speed was slower in their patients than in ours.…”

Section: Discussionmentioning

confidence: 59%

“…Some studies have reported an association between grip strength and grades 3-5 chemotherapy toxicities 32 . No association between gait speed and chemotherapy toxicity has previously been shown 32,39 , but several studies have noted an association between a tug test result exceeding 20 s and death within 6 months 34 , functional decline 38 , and early chemotherapy discontinuation 37 . The association that we observed between gait speed and chemotherapy toxicity requires confirmation in a larger study.…”

Section: Discussionmentioning

confidence: 99%

Pilot of Three Objective Markers of Physical Health and Chemotherapy Toxicity in Older Adults

et al. 2015

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Functional Decline in Older Patients With Cancer Receiving First-Line Chemotherapy

Cited by 212 publications

References 41 publications

Physical performance measures for predicting outcome in cancer patients: a systematic review

Physical performance measures for predicting outcome in cancer patients: a systematic review

What Every Oncologist Should Know About Geriatric Assessment for Older Patients With Cancer: Young International Society of Geriatric Oncology Position Paper

Pilot of Three Objective Markers of Physical Health and Chemotherapy Toxicity in Older Adults

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