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Association of frailty with chemotherapy toxicity in chemotherapy-naive older patients with cancer

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Abstract 

Objective

The purpose of this study is to assess the relationship between chemotherapy toxicity and frailty as determined using the Edmonton Frail Scale (EFS).

Methods

Older adults (≥ 65 years old) newly diagnosed with cancer were evaluated for frailty with EFS prior to chemotherapy. Participants evaluated on 17 points were grouped as “No Frailty” (0–4), “Apparently Vulnerable” (5–6), “Mild Frailty” (7–8), “Moderate Frailty” (9–10), and “Severe Frailty” (11 or more). Before the second and third chemotherapy cycles, patients were reassessed for toxicity.

Results

Of the 44 participants, 12 (27.4%) were rated as “frail” (EFS score ≥ 7). The median Charlson Age-Comorbidity Index score was 3 (IQR: 1), and the median EFS score was 5 (IQR: 3). There was no significant difference between the “frail” and “robust” groups in terms of the toxicity. There was no correlation between age, gender, chemotherapy intent, chemotherapy dosing, ECOG performance score, or other parameters with grade 3 or higher toxicity development.

Conclusion

The Edmonton Frail Scale is not successful in predicting the toxicity risk of chemotherapy. However, it may be used as a tool to determine the need for comprehensive geriatric assessment and it may lead to increased alertness to adverse events during treatment of frail patients.

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Data availability

The datasets generated during and/or analyzed during the current study are not publicly available due to ethical concerns but are available from the corresponding author on reasonable request.

Code availability

N/A.

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Authors

Contributions

All authors contributed to the design and implementation of the research, to the analysis of the results, and to the writing of the manuscript.

Corresponding author

Correspondence to Ilgın Akbıyık.

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The authors declare no competing interests.

Ethics approval

This study received the approval of Hacettepe University Non-interventional Clinical Research Ethics Committee.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Akbıyık, I., Yüce, D., Kars, A. et al. Association of frailty with chemotherapy toxicity in chemotherapy-naive older patients with cancer. Support Care Cancer 30, 9975–9981 (2022). https://doi.org/10.1007/s00520-022-07448-x

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  • DOI: https://doi.org/10.1007/s00520-022-07448-x

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