Predicting chemotherapy toxicity in older adults: Comparing the predictive value of the CARG Toxicity Score with oncologists' estimates of toxicity based on clinical judgement

Moth, Erin; Kiely, Belinda E; Stefanic, Natalie; Naganathan, Vasi; Martin, Andrew; Grimison, Peter; Stockler, Martin R.; Beale, Philip; Blinman, Prunella

doi:10.1016/j.jgo.2018.08.010

Cited by 45 publications

(40 citation statements)

References 31 publications

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“…In addition, treatments and follow-up were from a single centre and the reproducibility of the data in other populations and practice settings remain uncertain. Our cohort, for example, had a higher rate of grade 3 and 4 toxicities (72%) than these reported by other investigators (Moth et al, 2019;Nishijima et al, 2018). This may be due to inclusion of older patients in our study as well as inclusion of the adverse effects occurring in the month following the last dose of chemotherapy in order to capture late toxicities.…”

Section: Discussionmentioning

confidence: 81%

“…One study (Nishijima et al, ) was able to reproduce the results of the proponents of the CARG tool and observed essentially similar grade 3 and 4 toxicity percentages with those of the CARG study (Hurria et al, ) that were 33%, 50% and 81% in the low, intermediate and high‐risk categories respectively. In contrast, other investigators concluded that the CARG score did not predict toxicity and showed that in their series the score had an area under the receiver operating characteristic (AU‐ROC) curve of 0.52, close to random discrimination (Moth et al, ).…”

Section: Discussionmentioning

confidence: 93%

“…The inclusion of these elements in the tool may decrease its utility as choices of dose type and intensity would be among the decisions that the tool tries to advise about. In addition, the reproducibility of the predictions of the tool in populations beyond the population of the study remains uncertain, as conflicting results have been reported by other investigators (Moth et al, ; Nishijima et al, ). One study (Nishijima et al, ) was able to reproduce the results of the proponents of the CARG tool and observed essentially similar grade 3 and 4 toxicity percentages with those of the CARG study (Hurria et al, ) that were 33%, 50% and 81% in the low, intermediate and high‐risk categories respectively.…”

Section: Discussionmentioning

confidence: 96%

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Prediction of hospital admissions and grade 3–4 toxicities in cancer patients 70 years old and older receiving chemotherapy

et al. 2019

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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.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 96%

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Prediction of hospital admissions and grade 3–4 toxicities in cancer patients 70 years old and older receiving chemotherapy

et al. 2019

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“…Finally, our study was not designed to assess whether the CARG chemotherapy toxicity risk calculator was able to predict toxicity among older Brazilian adults with cancer. This, however, might be relevant in light of recent findings suggesting that the predictive value of the CARG score might vary in different geographic settings with differing practice patterns [32].…”

Section: Discussionmentioning

confidence: 99%

Association between chemotherapy toxicity risk scores and physical symptoms among older Brazilian adults with cancer

Bergerot

Razavi

Philip

et al. 2020

Journal of Geriatric Oncology

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“…The reason for assessing chemotherapy-associated toxicity is because many of the adverse reactions could be avoided or minimized by performing a thorough evaluation after each chemotherapy cycle. [ 2 , 3 ] The possibility of avoiding or minimizing chemotherapy-associated toxicity is a highly relevant aspect in cancer patient care, mainly because of the impact it poses on the patient's quality of life, as well as the vital risk it can cause under some circumstances. [ 3 – 6 ]…”

Section: Introductionmentioning

confidence: 99%

Relationship between chemotherapy-induced adverse reactions and health-related quality of life in patients with breast cancer

et al. 2020

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Background and objectives: Chemotherapy does not only affect cancer cells; it also affects, to a greater or lesser degree, all other cells in the body. This toxicity should be assessed according to its severity, frequency, and duration, taking into account objective and subjective dimensions in its assessment. This assessment is a highly relevant aspect when providing care to chemotherapy patients, mainly due to the impact of the treatment on the patient's quality of life, as well as the vital risk it may imply under certain circumstances. For all this, the objective of this study was to assess the relationship between chemotherapy-associated adverse reactions and health-related quality of life in breast cancer patients. Materials and methods: With this purpose, a descriptive cross-sectional study was developed on 110 breast cancer patients who were treated with docetaxel, epirubicin, and cyclophosphamide. Results: It is worth highlighting the negative effect of nausea, dysgeusia, peripheral neuropathy, loss of appetite, myalgia, and peripheral edema on the quality of life. Likewise, it is worth mentioning peripheral neuropathy as the toxicity that affects a greater number of quality-of-life indicators. Conclusions: To sum up, it would be necessary to make health professionals aware of the importance of chemotherapy-associated adverse reactions.

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Predicting chemotherapy toxicity in older adults: Comparing the predictive value of the CARG Toxicity Score with oncologists' estimates of toxicity based on clinical judgement

Cited by 45 publications

References 31 publications

Prediction of hospital admissions and grade 3–4 toxicities in cancer patients 70 years old and older receiving chemotherapy

Prediction of hospital admissions and grade 3–4 toxicities in cancer patients 70 years old and older receiving chemotherapy

Association between chemotherapy toxicity risk scores and physical symptoms among older Brazilian adults with cancer

Relationship between chemotherapy-induced adverse reactions and health-related quality of life in patients with breast cancer

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