Acute radiotherapy toxicity in elderly patients managed by a multidisciplinary oncogeriatric model
OC-0591
Abstract
Acute radiotherapy toxicity in elderly patients managed by a multidisciplinary oncogeriatric model
Authors: Marzia Borgia1, Lucrezia Gasparini1, Luciana Caravatta1, Maria Taraborrelli1, Matteo Candeloro2, Ettore Porreca3, Domenico Genovesi1
1"SS Annunziata" Hospital, "G. D'Annunzio" University, Radiation Oncology Unit, Chieti, Italy; 2"G. D'Annunzio" University, Department of Innovative Technologies in Medicine and Dentistry, Chieti, Italy; 3University "G. D'Annunzio" of Chieti-Pescara, Department of Medical, Oral and Biotechnological Sciences, Chieti, Italy
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Purpose or Objective
Aging is considerably related to several comorbidities, but little is known about efficacy and toxicity of radiation therapy (RT) in the elderly patients since the latter are under-represented in clinical trials and data are limited to patients with fewer comorbidities.The detection of predictive factors of toxicity associated to a multidisciplinary management could allow a tailored treatment for these patients. In this study, we aimed to evaluate the correlation between acute toxicity and Charlson comorbidity index (CCI) in elderly (>75years) treated with curative RT.
Material and Methods
A prospective observational study was designed in our Center for all patients with >75 years, candidate for curative RT. These patients underwent Geriatric 8 questionnaire (G8q), before and at the end of RT. Patients with G8 score <14 were evaluated by a multidimensional geriatric assessment, investigating cognitive, functional, and nutritional domains, to define the frailty phenotype. Acute toxicity was evaluated by RTOG scale up to three months of the end of treatment. An analysis of correlation between the baseline CCI score calculated for each patient and acute RT toxicity was performed. Statistical analysis was performed using Fisher exact test for continues variables and the non-parametric Kruskal–Wallis test for categorical variables. P-values lower than 0.05 were considered significant.
Results
G8q was administered to 130 patients. Forty-seven of them (36.7%) resulted frail with a baseline G8 score<14(range 4-14); 31 of them underwent a multidimensional assessment. Acute toxicity grade > 2 was observed in 45 patients (47%). We evaluated associations between CCI score, G8 score and acute toxicity (Table1). Charlson comorbidity index resulted 5, 6 or 7 in 121 patients (93%) and >8 only in 9 patients (7%). The G8 score performed before and after treatment did not change according to the baseline CCI score and no correlation was observed between CCI score and toxicity (p=0.43). Male sex resulted to have an impact on acute toxicity, maybe related to the higher percentage of prostate cancer patients treated with RT that present acute events (p=0.07).
Conclusion
Our analysis did not show a correlation between CCI score and acute toxicity in elderly patients >75 years. The multidimensional evaluation resulted useful to obtain compliance to the treatment without increased toxicity. This model is currently applied in our daily clinical practice.