Muntinghe, F.O.W. (2018) The Role of Comprehensive Geriatric Assessment in Patients with Squamous Cell Carcinoma of the Head and Neck Treated with Curative (Chemo) Radiotherapy in Predicting Chemotherapy Tolerance, Treatment Related Toxicity and Quality of Life. thesis, Medicine.
Full text available on request.Abstract
Background Elderly head and neck squamous cell carcinoma (HNSCC) patients (≥70 years) are not receiving standard concomitant chemoradiotherapy (CRX). It can be questioned whether this is justified as chronological age is not per se a predictor of outcome in CRX. The primary aim of the present study is to find predictors for completing CRX in HNSCC patients, for severe toxicity and for decrease in quality of life (QoL). Methods Data from patients with HNSCC stage III / IV with an indication for primary CRX were included from the OncoLifeS database. Frailty and comorbidity were measured with the Groningen Frailty Indicator (GFI) and Geriatric 8 (G8) for frailty, and the Adult Comorbidity Evaluation (ACE-27) for comorbidities. Patients were assessed by Comprehensive Geriatric Assessment (CGA) prior to treatment. Primary outcomes were the association between CGA and CRX completion, toxicity and longitudinal QoL. Secondary outcomes were to see eligibility for CRX using biological age. Results Seventy-one patients were enrolled with a median age of 63.2 [44 – 84] years old, of whom 45 (63%) received CRX. Patients who completed CRX, as compared to those who did not, were of the same age but tended to have less comorbidities (15% versus 27%, not significant). Score on frailty indices did not differ between groups (GFI 2.0 versus 2.0, G8 14.0 versus 14.5). The items of CGA were unable to predict severe toxicity at 3 and 6 months. ACE-27 and GFI were superior in predicting change in QoL. Conclusion: None of the components of the CGA were able to predict CRX completion. In patients under the age of 70, age is not a predictor for completing CRX. Changing the indication might lead to a lower percentage of patients with a CRX indication, but with a higher age. No consistent predictors for toxicity after both 3 and 6 months after treatment were identified. Change in QoL seems to be predictable by frailty and comorbidity
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Halmos, Dr. GB1 and 1Department of Otorhinolaryngology, Head and Neck Surgery and Oosting, Dr. SF and 2Department of Medical Oncology, University Medical Center G and Bock, Prof. Dr. GH de 3 and 3Department of Epidemiology, University Medical Center Groni |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:08 |
| Last Modified: | 25 Jun 2020 11:08 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2731 |
Actions (login required)
 |
View Item |