Longitudinal Trajectories of Frailty in Middle-Aged and Elderly Patients Undergoing Radiotherapy for Lung Cancer and...

Objective To explore the change trajectories of frailty in middle-aged and elderly patients undergoing radiotherapy for lung cancer and their influencing factors,thus providing a theoretical basis for targeted frailty management. Methods A prospective longitudinal study was conducted.Middle-aged and elderly patients with lung cancer who received radiotherapy in Yunnan Cancer Hospital were recruited by convenience sampling from January 2023 to December 2024.The general information questionnaire was used to investigate the baseline and disease-related data of patients at three time points:1 day before radiotherapy,at the end of radiotherapy,and 1 month after radiotherapy.The Fried Frailty scale was adopted to identify frailty at each time point.A latent class growth model was employed to analyze the change trajectories of frailty in middle-aged and elderly patients undergoing radiotherapy for lung cancer.Multinomial logistic regression was performed to analyze the influencing factors of different trajectories. Results A total of 327 middle-aged and elderly patients completed the follow-up.The incidence of frailty was 27.83% before radiotherapy,48.32% at the end of radiotherapy,and 29.36% one month after radiotherapy.The frailty trajectory categories of patients undergoing radiotherapy for lung cancer could be classified into a pre-frailty-decline group (56.58%),a frailty-gentle increase group (27.83%),and a severe frailty-continuous increase group (15.60%).Age,nutritional score,disease stage,and the therapy received were the influencing factors of frailty trajectory category (all P<0.05). Conclusions There is heterogeneity in the frailty trajectories of middle-aged and elderly patients with lung cancer before and one month after radiotherapy.Medical staff can formulate targeted frailty management strategies according to the heterogeneity and influencing factors of frailty trajectories to help patients prevent or reverse the occurrence of frailty and further improve the quality of life of patients.