Lorna G Keenan1, Michelle O'Brien2, Tim Ryan2, Mary Dunne2, Orla McArdle2. 1. St Lukes Radiation Oncology Network, St Lukes Hospital, Rathgar, Dublin 6, Ireland. Electronic address: lornakeenan@gmail.com. 2. St Lukes Radiation Oncology Network, St Lukes Hospital, Rathgar, Dublin 6, Ireland.
Abstract
OBJECTIVE: In this study we evaluate the usefulness of the Edmonton Frail Scale (EFS) in predicting which older patients are at risk of developing serious toxicities during radiotherapy. MATERIALS AND METHODS: This prospective study was carried out over an 18month period. Our primary aim was to examine the Edmonton Frail Scale (EFS) as a predictor of toxicity in patients over 70years undergoing radical radiotherapy for any malignant diagnosis. RESULTS: 63 patients were recruited: 29% experienced grade 3 or greater toxicities, with very few having multiple grade 3 or greater toxicities. The majority of patients experienced multiple grade 1 or 2 toxicities. Patients were often admitted: either electively due to geographical reasons, or due to toxicities. All patients completed their courses of radiotherapy. All grade 3 or 4 toxicities occurred within five radiotherapy sites; upper GI, gynaecological, lung, prostate and head & neck. There was no statistical correlation between EFS score and the presence of grade 3 or 4 toxicities. CONCLUSION: This study showed that neither EFS score, age nor ECOG performance status were predictive of radiotherapy toxicity, breaks in treatment or hospital admissions. Patients with oesophageal cancer, gynaecological cancers and lung cancer had a high rate of toxicity and hospital admission, which may highlight the need for additional patient support in these groups. Whilst comprehensive geriatric assessment is recommended, further research is needed to conclude if the frail elderly patient is at greater risk of toxicities from radiotherapy, and which geriatric assessment tool may be the most helpful.
OBJECTIVE: In this study we evaluate the usefulness of the Edmonton Frail Scale (EFS) in predicting which older patients are at risk of developing serious toxicities during radiotherapy. MATERIALS AND METHODS: This prospective study was carried out over an 18month period. Our primary aim was to examine the Edmonton Frail Scale (EFS) as a predictor of toxicity in patients over 70years undergoing radical radiotherapy for any malignant diagnosis. RESULTS: 63 patients were recruited: 29% experienced grade 3 or greater toxicities, with very few having multiple grade 3 or greater toxicities. The majority of patients experienced multiple grade 1 or 2 toxicities. Patients were often admitted: either electively due to geographical reasons, or due to toxicities. All patients completed their courses of radiotherapy. All grade 3 or 4 toxicities occurred within five radiotherapy sites; upper GI, gynaecological, lung, prostate and head & neck. There was no statistical correlation between EFS score and the presence of grade 3 or 4 toxicities. CONCLUSION: This study showed that neither EFS score, age nor ECOG performance status were predictive of radiotherapy toxicity, breaks in treatment or hospital admissions. Patients with oesophageal cancer, gynaecological cancers and lung cancer had a high rate of toxicity and hospital admission, which may highlight the need for additional patient support in these groups. Whilst comprehensive geriatric assessment is recommended, further research is needed to conclude if the frail elderly patient is at greater risk of toxicities from radiotherapy, and which geriatric assessment tool may be the most helpful.
Authors: Simon J G Richards; Frank A Frizelle; John A Geddes; Tim W Eglinton; Mark B Hampton Journal: Int J Colorectal Dis Date: 2018-09-14 Impact factor: 2.571
Authors: James M Wilson; David P Dearnaley; Isabel Syndikus; Vincent Khoo; Alison Birtle; David Bloomfield; Ananya Choudhury; John Graham; Catherine Ferguson; Zafar Malik; Julian Money-Kyrle; Joe M O'Sullivan; Miguel Panades; Chris Parker; Yvonne Rimmer; Christopher Scrase; John Staffurth; Andrew Stockdale; Clare Cruickshank; Clare Griffin; Emma Hall Journal: Int J Radiat Oncol Biol Phys Date: 2018-01-09 Impact factor: 7.038