1. Prevalence and Predictive Factors for Upfront Dose Reduction of the First Cycle of First-Line Chemotherapy in Older Adults with Metastatic Solid Cancer: Korean Cancer Study Group (KCSG) Multicenter Study
- Author
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In Gyu Hwang, Su Jin Koh, In Sook Woo, Kyung Hee Lee, Jung Hye Kwon, Minsuk Kwon, Jin Won Kim, Sun Young Kim, Myung Ah Lee, Hyun Jung Kim, Sung Hwa Bae, Dong Hoe Koo, Soojung Hong, Seong Hoon Shin, Hyo Jung Kim, Yun Gyoo Lee, Yong Sang Hong, Tae Yong Kim, Se Hyun Kim, Jin Young Kim, Yoon Ho Ko, and Jee Hyun Kim
- Subjects
Oncology ,Cancer Research ,medicine.medical_specialty ,Multivariate analysis ,medicine.medical_treatment ,chemotherapy ,lcsh:RC254-282 ,Article ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,030212 general & internal medicine ,Dosing ,predictive ,Radiation treatment planning ,Adverse effect ,older adults ,Chemotherapy ,business.industry ,Cancer ,medicine.disease ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,dosing ,Spouse ,030220 oncology & carcinogenesis ,Dose reduction ,business - Abstract
Old age alone does not reflect an intolerability to chemotherapy. However, upfront dose reduction (UDR) of the first cycle of first-line palliative chemotherapy has sometimes been chosen by physicians for older adults with metastatic cancer due to concerns regarding adverse events. The development of predictive factors for UDR of palliative chemotherapy would be helpful for treatment planning among older adults. This was a secondary analysis of a study on predicting adverse events of first-line palliative chemotherapy in 296 patients (&ge, 70 years) with solid cancer. We assessed the prevalence of UDR of the first cycle of first-line chemotherapy and the association of UDR with the variables of geriatric assessment (GA) and chemotherapy compliance. Among the 296 patients, 177 (59.8%) patients were treated with UDR. The mean percentage of UDR for the total patient group was 19.2% (range: 4&ndash, 47%) of the standard dose. In a multivariate analysis, poor performance status (PS) and living without a spouse were independent predictive factors of UDR of first-line palliative chemotherapy in older adults. Patients with UDR showed fewer grade 3&ndash, 5 adverse events versus the standard dose group. Study completion as planned was significantly higher in the UDR group versus the standard dose group. Older adults with UDR better tolerated chemotherapy than patients with a standard dose.
- Published
- 2021