PMID- 35675788
OWN - NLM
STAT- MEDLINE
DCOM- 20221102
LR  - 20221102
IS  - 2296-5262 (Electronic)
IS  - 2296-5270 (Linking)
VI  - 45
IP  - 11
DP  - 2022
TI  - Sequential Geriatric Assessment in Older Patients with Colorectal Cancer during 
      Chemotherapy: Subgroup Analysis of a Prospective, Multicenter Study EpiReal 75.
PG  - 670-680
LID - 10.1159/000525101 [doi]
AB  - INTRODUCTION: Colorectal cancer (CRC) is a disease of older patients, but 
      evidence-based guidelines for chemotherapy in older patients are scarce. 
      Geriatric assessment (GA) evaluates a patient's functional status (FS) and helps 
      in decision-making when choosing chemotherapy for older patients. However, the 
      change of FS during chemotherapy is rarely studied as GA is mostly performed once 
      instead of sequentially. METHODS: We performed a subgroup analysis of a 
      prospective, multicenter study EpiReal 75. Patients aged >/=75 years with 
      gastrointestinal malignancy prior to initiation of chemotherapy or receiving 
      palliative chemotherapy were screened. We defined geriatric core assessments 
      including the Eastern Cooperative Oncology Group score, Barthel's activities of 
      daily living (ADL) scale, Lawton's instrumental activities of daily living (IADL) 
      scale, and G-8 questionnaire, which were performed at baseline and repeated every 
      3 months. Quality of life (QoL) assessed by QLQ-C30 questionnaire was also 
      re-evaluated every 3 months. We defined any deterioration in any of the geriatric 
      parameters as unstable in the corresponding function. RESULTS: 28 patients with 
      CRC were enrolled between April 2014 and December 2018. 20 patients were 
      evaluable for statistical analysis with a mean age of 78.5 years (range, 75-88). 
      Most patients received chemotherapy in palliative setting. During 3 months of 
      chemotherapy, 25% of patients became more dependent as measured by ADL or IADL. 
      During a median follow-up of 15 months, patients with unstable ADL or IADL had a 
      significantly shorter overall survival (OS) than those with stable ADL or IADL 
      (plogrank = 0.0055 and 0.0253, respectively), without a significant difference in 
      progression-free survival (PFS). Also, unstable IADL correlated with a 
      deterioration in aspects of QoL such as role functioning and emotional 
      functioning (p = 0.0189 and 0.0239, respectively). 20% of patients experienced 
      treatment-related grade 3 adverse events (AEs), no grade 4-5 AEs occurred. 
      CONCLUSION: Sequential GA revealed changes in FS in older patients with CRC 
      receiving chemotherapy. A deterioration of FS during chemotherapy did not 
      influence PFS but had a negative impact on OS and QoL. It is therefore important 
      to maintain FS in older patients with cancer, and regular performance of 
      geriatric core assessments should be encouraged in the clinical practice.
CI  - (c) 2022 S. Karger AG, Basel.
FAU - Li, Moying
AU  - Li M
AD  - Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, 
      Mannheim, Germany, moying.li@umm.de.
AD  - Mannheim Cancer Center, Medical Faculty Mannheim, Heidelberg University, 
      Mannheim, Germany, moying.li@umm.de.
FAU - Schulte, Nadine
AU  - Schulte N
AD  - Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, 
      Mannheim, Germany.
AD  - Mannheim Cancer Center, Medical Faculty Mannheim, Heidelberg University, 
      Mannheim, Germany.
FAU - Elting, Frederik
AU  - Elting F
AD  - Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, 
      Mannheim, Germany.
FAU - Winkler, Eva C
AU  - Winkler EC
AD  - Department of Medical Oncology, National Center for Tumor Diseases (NCT), 
      Heidelberg University Hospital, Heidelberg, Germany.
FAU - Hetjens, Svetlana
AU  - Hetjens S
AD  - Department of Medical Statistics and Biomathematics, Medical Faculty Mannheim, 
      Heidelberg University, Mannheim, Germany.
FAU - Berger, Anne Katrin
AU  - Berger AK
AD  - Department of Medical Oncology, National Center for Tumor Diseases (NCT), 
      Heidelberg University Hospital, Heidelberg, Germany.
FAU - Zschabitz, Stefanie
AU  - Zschabitz S
AD  - Department of Medical Oncology, National Center for Tumor Diseases (NCT), 
      Heidelberg University Hospital, Heidelberg, Germany.
FAU - Hofmann, Jan
AU  - Hofmann J
AD  - Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, 
      Mannheim, Germany.
FAU - Hofmann, Jasmin
AU  - Hofmann J
AD  - Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, 
      Mannheim, Germany.
FAU - Hilbertz, Lieselotte
AU  - Hilbertz L
AD  - Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, 
      Mannheim, Germany.
FAU - Kuhn, Merlin
AU  - Kuhn M
AD  - Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, 
      Mannheim, Germany.
FAU - Khakzar, Carolin
AU  - Khakzar C
AD  - Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, 
      Mannheim, Germany.
FAU - Jesenofsky, Ralf
AU  - Jesenofsky R
AD  - Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, 
      Mannheim, Germany.
AD  - Mannheim Cancer Center, Medical Faculty Mannheim, Heidelberg University, 
      Mannheim, Germany.
FAU - Betge, Johannes
AU  - Betge J
AD  - Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, 
      Mannheim, Germany.
AD  - Mannheim Cancer Center, Medical Faculty Mannheim, Heidelberg University, 
      Mannheim, Germany.
AD  - Junior Clinical Cooperation Unit Translational Gastrointestinal Oncology and 
      Preclinical Models, German Cancer Research Center (DKFZ), Heidelberg, Germany.
AD  - DKFZ-Hector Cancer Institute at the University Medical Center Mannheim, Mannheim, 
      Germany.
FAU - Zhan, Tianzuo
AU  - Zhan T
AD  - Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, 
      Mannheim, Germany.
AD  - Mannheim Cancer Center, Medical Faculty Mannheim, Heidelberg University, 
      Mannheim, Germany.
FAU - Belle, Sebastian
AU  - Belle S
AD  - Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, 
      Mannheim, Germany.
AD  - Mannheim Cancer Center, Medical Faculty Mannheim, Heidelberg University, 
      Mannheim, Germany.
FAU - Ebert, Matthias Philip
AU  - Ebert MP
AD  - Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, 
      Mannheim, Germany.
AD  - Mannheim Cancer Center, Medical Faculty Mannheim, Heidelberg University, 
      Mannheim, Germany.
AD  - DKFZ-Hector Cancer Institute at the University Medical Center Mannheim, Mannheim, 
      Germany.
FAU - Hartel, Nicolai
AU  - Hartel N
AD  - Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, 
      Mannheim, Germany.
AD  - Mannheim Cancer Center, Medical Faculty Mannheim, Heidelberg University, 
      Mannheim, Germany.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20220608
PL  - Switzerland
TA  - Oncol Res Treat
JT  - Oncology research and treatment
JID - 101627692
SB  - IM
MH  - Aged
MH  - Humans
MH  - Geriatric Assessment
MH  - Quality of Life
MH  - Activities of Daily Living
MH  - Prospective Studies
MH  - *Gastrointestinal Neoplasms
MH  - *Colorectal Neoplasms/drug therapy
OTO - NOTNLM
OT  - Colorectal cancer
OT  - Functional status
OT  - Older patients with cancer
OT  - Overall survival
OT  - Quality of life
OT  - Sequential geriatric assessment
EDAT- 2022/06/09 06:00
MHDA- 2022/11/03 06:00
CRDT- 2022/06/08 18:23
PHST- 2022/01/22 00:00 [received]
PHST- 2022/05/06 00:00 [accepted]
PHST- 2022/06/09 06:00 [pubmed]
PHST- 2022/11/03 06:00 [medline]
PHST- 2022/06/08 18:23 [entrez]
AID - 000525101 [pii]
AID - 10.1159/000525101 [doi]
PST - ppublish
SO  - Oncol Res Treat. 2022;45(11):670-680. doi: 10.1159/000525101. Epub 2022 Jun 8.