Clinical Significance of Frailty on Treatment Outcome in Nongeriatric Patients With Head and Neck Cancer and Esophageal Cancer Undergoing Curative-Intent Concurrent Chemoradiotherapy

Wen-Chi Chou*, Cheng Chou Lai, Chia Yen Hung, Shun Wen Hsueh, Kun Yun Yeh, Chang Hsien Lu, Ngan-Ming Tsang, Pei Hung Chang, Ya Wen Ho, Shih Ying Chen, Yu Ching Lin, Yu Shin Hung

*此作品的通信作者

研究成果: 期刊稿件文章同行評審

10 引文 斯高帕斯(Scopus)

摘要

Background: Whether the prevalence of frailty and its clinical significance are relevant to treatment outcomes in younger (aged < 65 years) cancer patients remains uncertain. This study aimed to evaluate the impact of frailty on treatment outcomes in younger cancer patients with head and neck and esophageal malignancy. Material and methods: This multicenter prospective study recruited 502 patients with locally advanced head and neck and esophageal cancer during 2016–2017 in Taiwan, aged 20–64 years who received curative-intent concurrent chemoradiotherapy (CCRT) as first-line antitumor treatment. Baseline frailty assessment using geriatric assessment (GA) was performed for each patient within 7 days before CCRT initiation. Results: Frailty was observed in 169 (33.7%) of 502 middle-aged patients. Frail patients had significantly higher incidences of chemotherapy incompletion (16.6% versus 3.3%, P <.001) and radiotherapy incompletion (16.6% versus 3.6%, P <.001) than fit patients. During CCRT, frail patients had a significantly higher percentage of hospitalizations (42.0% versus 24.6%, P <.001) and a trend toward a higher percentage of emergency room visits (37.9% versus 30.0%, P =.08) than fit patients. Frail patients more likely had a significantly higher incidence of grade ≥ 3 adverse events than fit patients during CCRT. The 1-year survival rate was 68.7% and 85.2% (hazard ratio 2.56, 95% confidence interval 1.80–3.63, P <.001) for frail and fit patients, respectively. Conclusions: This study demonstrated the significance of pretreatment frailty on treatment tolerance, treatment-related toxicity, and survival outcome in younger patients with head and neck and esophageal cancer undergoing CCRT. While GA is commonly targeted toward the older population, frailty assessment by GA may also be utilized in younger patients for decision-making guidance and prognosis prediction.

原文英語
期刊Cancer Control
29
DOIs
出版狀態已出版 - 01 01 2022

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© The Author(s) 2022.

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