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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

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Abstract
Simple Summary

Arbitrary upfront dose reduction (UDR) of palliative chemotherapy has often been performed according to the judgement of the physician of older adults with metastatic solid cancer in current practice. UDR might decrease treatment efficacy in older adults but may be helpful for palliation, so selecting older adults who benefit from UDR and the identification of predictors of UDR are required. The authors investigated the prevalence and predictors of UDR through variables of geriatric assessment (GA). Chemotherapy compliance between the UDR and standard dose patient groups was also compared. The results of this study demonstrated that approximately 60% of older adults with metastatic solid cancer received UDR. Poor performance status (PS) and living without a spouse were predictive factors of UDR of first-line palliative chemotherapy, and patients with UDR better-tolerated chemotherapy compared with patients with standard doses.

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 (>= 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: 4-47%) 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 3-5 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.
Author(s)
고수진고윤호구동회권민석권정혜김선영김세현김지현김진영김진원김태용김현정김효정배성화신성훈우인숙이경희이명아이윤구홍수정홍용상황인규
Issued Date
2021
Type
Article
Keyword
chemotherapydosingolder adultspredictive.
DOI
10.3390/cancers13020331
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8468
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_9fe676cac703405eb0a7fdb29dd42258&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Prevalence%20and%20Predictive%20Factors%20for%20Upfront%20Dose%20Reduction%20of%20the%20First%20Cycle%20of%20First-Line%20Chemotherapy%20in%20Older%20Adults%20with%20Metastatic%20Solid%20Cancer:%20Korean%20Cancer%20Study%20Group%20(KCSG)%20Multicenter%20Study&offset=0&pcAvailability=true
Publisher
CANCERS
Location
스위스
Language
한국어
ISSN
2072-6694
Citation Volume
13
Citation Number
2
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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