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Geriatric Assessment as a Predictor of Tolerance, Quality of Life, and Outcomes in Older Patients With Head and Neck Cancers and Lung Cancers Receiving Radiation Therapy.

Publication ,  Journal Article
VanderWalde, NA; Deal, AM; Comitz, E; Stravers, L; Muss, H; Reeve, BB; Basch, E; Tepper, J; Chera, B
Published in: Int J Radiat Oncol Biol Phys
July 15, 2017

PURPOSE: To evaluate the association between functional status based on a geriatric assessment (GA) and outcomes of tolerance to treatment in patients with lung or head and neck cancer receiving radiation therapy (RT) or chemoradiation (CRT). METHODS AND MATERIALS: A prospective cohort study was conducted in patients aged ≥65 years with head and neck cancer or lung cancer undergoing curative intent RT or CRT. Pretreatment GA, health-related quality of life (HRQoL), and patient-reported outcomes (PRO) were obtained. Questionnaires were repeated biweekly during RT and at 6 weeks after treatment. Dysfunction was defined as scores <14 on the Instrumental Activities of Daily Living scale. Poor tolerance to treatment was defined by hospitalization, >3-day treatment delay, change in RT or CRT regimen, or death. Associations of dysfunction with tolerance to radiation therapy, HRQoL changes, and PRO ratings were evaluated. RESULTS: Of the 50 patients accrued, 46 had evaluable data. Mean age was 72.5 years (range, 65-92 years). At baseline, 37% had dysfunction. Poor tolerance to RT or CRT occurred in 39%. There was no association between dysfunction and tolerance. Patients with dysfunction had lower baseline HRQoL scores. From baseline to end of RT, those with baseline dysfunction had less of a decline in Role Functioning (P=.01) and Global Health Score (P=.04) domains. However, from end of RT to 6-week follow-up, those with dysfunction were more likely to continue to drop in the Physical, Role Functioning, and Social domains (all P<.01). Dysfunction at baseline was also associated with higher severity of certain PROs. CONCLUSIONS: Pretreatment dysfunction was associated with continued decline and lack of recovery of HRQoL in this patient population. Larger studies could further elucidate the GA's predictive value.

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Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

July 15, 2017

Volume

98

Issue

4

Start / End Page

850 / 857

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surveys and Questionnaires
  • Radiotherapy
  • Quality of Life
  • Prospective Studies
  • Patient Reported Outcome Measures
  • Patient Acuity
  • Oncology & Carcinogenesis
  • North Carolina
  • Male
 

Citation

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VanderWalde, N. A., Deal, A. M., Comitz, E., Stravers, L., Muss, H., Reeve, B. B., … Chera, B. (2017). Geriatric Assessment as a Predictor of Tolerance, Quality of Life, and Outcomes in Older Patients With Head and Neck Cancers and Lung Cancers Receiving Radiation Therapy. Int J Radiat Oncol Biol Phys, 98(4), 850–857. https://doi.org/10.1016/j.ijrobp.2016.11.048
VanderWalde, Noam A., Allison M. Deal, Elizabeth Comitz, Lori Stravers, Hyman Muss, Bryce B. Reeve, Ethan Basch, Joel Tepper, and Bhishamjit Chera. “Geriatric Assessment as a Predictor of Tolerance, Quality of Life, and Outcomes in Older Patients With Head and Neck Cancers and Lung Cancers Receiving Radiation Therapy.Int J Radiat Oncol Biol Phys 98, no. 4 (July 15, 2017): 850–57. https://doi.org/10.1016/j.ijrobp.2016.11.048.
VanderWalde NA, Deal AM, Comitz E, Stravers L, Muss H, Reeve BB, et al. Geriatric Assessment as a Predictor of Tolerance, Quality of Life, and Outcomes in Older Patients With Head and Neck Cancers and Lung Cancers Receiving Radiation Therapy. Int J Radiat Oncol Biol Phys. 2017 Jul 15;98(4):850–7.
VanderWalde, Noam A., et al. “Geriatric Assessment as a Predictor of Tolerance, Quality of Life, and Outcomes in Older Patients With Head and Neck Cancers and Lung Cancers Receiving Radiation Therapy.Int J Radiat Oncol Biol Phys, vol. 98, no. 4, July 2017, pp. 850–57. Pubmed, doi:10.1016/j.ijrobp.2016.11.048.
VanderWalde NA, Deal AM, Comitz E, Stravers L, Muss H, Reeve BB, Basch E, Tepper J, Chera B. Geriatric Assessment as a Predictor of Tolerance, Quality of Life, and Outcomes in Older Patients With Head and Neck Cancers and Lung Cancers Receiving Radiation Therapy. Int J Radiat Oncol Biol Phys. 2017 Jul 15;98(4):850–857.
Journal cover image

Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

July 15, 2017

Volume

98

Issue

4

Start / End Page

850 / 857

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Surveys and Questionnaires
  • Radiotherapy
  • Quality of Life
  • Prospective Studies
  • Patient Reported Outcome Measures
  • Patient Acuity
  • Oncology & Carcinogenesis
  • North Carolina
  • Male