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化疗相关的毒性影响以及老年患者的生活质量和身体功能
Joosje C Baltussen1, Nienke A de Glas1, Yara van Holstein2
1Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands.
JAMA network open
|October 23, 2023
概括
接受化疗的老年患者经历了更严重的毒性影响,影响了他们的生活质量和身体功能. 早期的脆弱性查和量身定制的治疗对于防止这种脆弱人群的负面结果至关重要.
科学领域:
- 老年瘤学 老年瘤学
- 临床药理学 临床药理学
- 患者报告的结果
背景情况:
- 老年人更容易受到与化疗相关的严重毒性影响.
- 这些毒性影响对老年患者的生活质量 (QOL) 和身体功能的影响仍未得到充分研究.
研究的目的:
- 在70岁及以上的患者中,检查化疗相关的严重 (3级或更高) 毒性影响与随时间推移的QOL和身体功能之间的关联.
主要方法:
- 一项前性多中心队列研究包括276名70岁以上的预定接受化疗的患者.
- 老年人的评估发现了脆弱性. 质量生活和身体功能在基线,6个月和12个月被评估.
- 多变量后勤回归分析了毒性影响与复合终点 (质量生活/身体功能或死亡率下降) 之间的关联.
主要成果:
- 虚弱的患者 (53%) 经历了更多的3级+毒性影响 (65%vs. 50%) 和更糟糕的结果 (76%vs. 64-68%的下降/死亡率).
- 在脆弱患者中,严重的毒性影响与6个月后的复合终点 (OR 2.62) 和12个月后的死亡率 (OR 3.54) 有关.
- 在非脆弱患者中,毒性作用和不良结果之间没有发现显著的关联.
结论:
- 在接受化疗的老年人中,虚弱与严重毒性作用的增加以及较差的QOL,身体功能和生存率有关.
- 严重的毒性影响显著影响了脆弱患者的结果,但没有影响非脆弱患者的结果.
- 治疗前的脆弱性评估和个性化治疗策略对于减轻老年癌症患者与治疗相关的健康状况下降至关重要.
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