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开发和验证ACTTOP:在老年患有固体恶性瘤的老年患者中预测抗癌治疗严重毒性的预测模型
Wing Lok Chan1, Holly Li-Yu Hou1, Horace Chuek-Wai Choi2
1Department of Clinical Oncology, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR.
Age and ageing
|November 9, 2025
概括
一个新的工具,抗癌治疗对老年患者的毒性 (ACTTOP),准确地预测了癌症老年人的严重治疗相关毒性. 这种经过验证的模型有助于个性化风险评估,以获得更好的患者结果.
科学领域:
- 老年瘤学 老年瘤学
- 临床药理学 临床药理学
- 生物统计学 生物统计学
背景情况:
- 患有癌症的老年人面临更高的严重治疗相关毒性 (TRT) 风险.
- 预测化疗毒性的现有模型具有显著的局限性.
- 需要一种可靠的工具来预测在接受全身治疗的老年癌症患者中严重的TRT.
研究的目的:
- 开发和验证在接受全身抗癌治疗的老年患者中严重TRT的预测工具.
- 确定与严重TRT相关的关键临床,瘤,实验室和老年因素.
- 将开发的工具的性能与CARG.等现有模型进行比较.
主要方法:
- 在三个香港瘤中心招募接受全身治疗的65岁以上患者 (2019年3月 - 2023年6月).
- 收集治疗前数据,包括临床,瘤/治疗,实验室和老年变量.
- 在老年患者中抗癌治疗毒性 (ACTTOP) 评分系统的开发,使用多变量逻辑回归和其预测性表现的验证 (AUC,适合性).
主要成果:
- 该研究包括700名患者 (400名用于开发,300名用于验证),其中59.0%的人经历了3-5级TRT.
- 确定了10个预测因素,形成了ACTTOP评分,该评分将患者分为低风险,中风险和高风险组,具有不同的TRT率 (例如,高风险组:86.3%的发展,76.6%的验证).
- 与CARG评分 (AUC 0.61) 相比,ACTTOP表现出优越的预测能力 (验证时AUC 0.77),并且与不良结果有显著的关联.
结论:
- ACTTOP模型是个性化评估老年癌症患者严重治疗毒性风险的验证工具.
- ACTTOP促进了个性化的风险分层,可能改善治疗规划和患者管理.
- 该工具解决了现有模型的局限性,并为老年瘤学人群中严重的TRT提供了更高的预测准确性.
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