Background: Older patients are vulnerable to chemotherapy-related toxicity (CRT). Therefore we evaluated
screening tools in their power to predict CRT.
Methods: Patients with cancer aged ≥65 years completed three screening questionnaires (G8, optimised G8 and
Cancer and Ageing Research Group (CARG). Additionally, Comprehensive geriatric assessment (CGA) for verification
of supportive care needs was undertaken on patients with impaired G8 scores. During chemotherapy
treatment patients were assessed, capturing grade 0–5 CRT as defined by NCI CTCAE 4.
Results: 104 patients with non-haematological cancers were included at three study sites. Median age was 73
years (range 65–85). Onco-geriatric screening detected 74% as impaired using G8 and optimised G8 questionnaires
and 86% using CARG screening. Grade 3–5 toxicity affected 64.4% of all patients. G8 (OR 0.3 95% CI
[0.1;1.0]) and optimised G8 (OR 0.4 95% CI [0.1; 1.5]) did not reliably predict CRT, whereas screening with
CARG demonstrated a strong prediction of severe CRT: OR 4.2, 95% CI [1.1, 15.9]. CGA was undertaken on 66 patients,
revealing deficiencies in nutritional (83%) and functional-status (54%) and occurrence of relevant comorbidity
(53%).
Conclusion: The CARG tool could be useful for predicting CRT. CGA showed clinically relevant supportive care
needs in patients with a positive G8 screening.:1. Einleitung ..................................................................................................................................... - 3 -
1.1 Epidemiologie der Krebserkrankungen bei älteren Patienten .................................................. - 4 -
1.2 Herausforderungen der geriatrischen Onkologie ..................................................................... - 5 -
1.3 Status Quo ................................................................................................................................. - 7 -
1.4 Geriatrisches Assessment (GA)................................................................................................ - 11 -
1.6 Geriatrisches Screening ........................................................................................................... - 13 -
1.5 Chemotherapie assoziierte Toxizität ....................................................................................... - 15 -
2 Ableitung der Studienrationale ...................................................................................................... - 17 -
3 Publikationsmanuskript .................................................................................................................. - 18 -
4 Zusammenfassung der Arbeit ........................................................................................................ - 26 -
5 Literaturverzeichnis der Einleitung ................................................................................................ - 29 -
6 Anlagen ........................................................................................................................................... - 35 -
7 Abkürzungsverzeichnis ................................................................................................................... - 52 -
8 Erklärung über die eigenständige Abfassung der Arbeit ................................................................ - 53 -
9 Lebenslauf – David Immanuel Kotzerke ......................................................................................... - 54 -
10 Spezifizierung des eigenen Beitrages ........................................................................................... - 56 -
11 Danksagungen .............................................................................................................................. - 58 -
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:74102 |
| Date | 05 March 2021 |
| Creators | Kotzerke, David Immanuel |
| Contributors | Universität Leipzig |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | German, English |
| Detected Language | English |
| Type | info:eu-repo/semantics/acceptedVersion, doc-type:doctoralThesis, info:eu-repo/semantics/doctoralThesis, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
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