We have located links that may give you full text access.
JOURNAL ARTICLE
MULTICENTER STUDY
Functional decline in older patients with cancer receiving chemotherapy: A multicenter prospective study.
Journal of Geriatric Oncology 2017 May
OBJECTIVES: This study aims to evaluate the evolution of functional status (FS) 2 to 3months after initiation of chemotherapy, to identify factors associated with functional decline during chemotherapy treatment and to investigate the prognostic value of functional decline for overall survival (OS).
PATIENTS AND METHODS: Patients ≥70years with a malignant tumor were included when chemotherapy was initiated. All patients underwent a geriatric assessment (GA) including FS measured by Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). FS of patients was followed by repeating ADL and IADL to identify functional decline.
RESULTS: From 10/2009 until 07/2011, 439 patients were included. At follow-up, ADL and IADL data were available for 387 patients. Functional decline in ADL and IADL was observed in 19.9% and 41.3% of the patients respectively. In multivariable logistic regression analysis, baseline factors associated with decline in ADL are abnormal nutritional status (OR:2.02) and IADL dependency (OR:1.76). Oncological setting (disease progression/relapse vs new diagnosis) (OR:0.59) is the only determinant of decline in IADL. Functional decline in ADL is strongly prognostic for OS (logrank p-value<.0001; Wilcoxon p-value<.0001) with HR 2.34 and functional decline in IADL is also prognostic for OS but less prominent with HR 1.25.
CONCLUSIONS: Functional decline occurs in about a third of older patients with cancer receiving chemotherapy and is associated with GA components. It strongly predicts survival, the most prominent for ADL. This knowledge can be used to identify older persons with cancer receiving chemotherapy eligible for interventions to prevent functional decline.
PATIENTS AND METHODS: Patients ≥70years with a malignant tumor were included when chemotherapy was initiated. All patients underwent a geriatric assessment (GA) including FS measured by Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). FS of patients was followed by repeating ADL and IADL to identify functional decline.
RESULTS: From 10/2009 until 07/2011, 439 patients were included. At follow-up, ADL and IADL data were available for 387 patients. Functional decline in ADL and IADL was observed in 19.9% and 41.3% of the patients respectively. In multivariable logistic regression analysis, baseline factors associated with decline in ADL are abnormal nutritional status (OR:2.02) and IADL dependency (OR:1.76). Oncological setting (disease progression/relapse vs new diagnosis) (OR:0.59) is the only determinant of decline in IADL. Functional decline in ADL is strongly prognostic for OS (logrank p-value<.0001; Wilcoxon p-value<.0001) with HR 2.34 and functional decline in IADL is also prognostic for OS but less prominent with HR 1.25.
CONCLUSIONS: Functional decline occurs in about a third of older patients with cancer receiving chemotherapy and is associated with GA components. It strongly predicts survival, the most prominent for ADL. This knowledge can be used to identify older persons with cancer receiving chemotherapy eligible for interventions to prevent functional decline.
Full text links
Related Resources
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app