CONCORDANCE OF CARG SCORE AND ASSOCIATIONS IN STRATIFICATIONS OF RISK OF TOXICITY TO CHEMOTHERAPY IN ELDERLY PATIENTS WITH CANCER

Introduction: The systemic treatment of cancer is associated to higher risk of appearance of toxicity in elderly patients in spite of tumor specific response rate. Scores as CRASH, CARG and G8 were created to stratify the risk of toxicity in aged patients diagnosticated with cancer before treatment with chemotherapy. Despite these scores show effective use in clinical trials, until now they are not able to supplement wide additional geriatric evaluations. AIMS: Analise the agreement of isolated CARG score associated to hand grip strength (HGS) to determine the risk of toxicity of first cycle of chemotherapy in elderly patients diagnosticated with cancer. Methods: Cross-sectional study performed in agreement to Chemotherapy Center between the period of 2017-2018. Inclusion criterias: Age ≥ 60 years; Both genders; Diagnostic of pathomorphological of non-hematological cancer; Without previous exposure to chemotherapy; Under initiation of first cycle of chemotherapy. Exclusion criterias: Patients under treatment of first cycle of selected target chemotherapy or immunotherapy. CARG score was filled, and HGS was evaluated using handgrip instrument following specific protocols. After 2nd/3rd week of first cycle of chemotherapy treatment patients were asked about present toxicities and they were graded following CTC-AE v2.0 criteria. Results: 151 patients were included; 80 female patients; average of age was 69 years old (60-87 years old); 92 patients under palliative chemotherapy. The most frequent toxicities were: Anorexia, neuropathy and nausea , graded as 52,3% II degree; 22,5% I degree and 24,5% III-IV degree. Through kappa coefficient (kappa = 0.13) (IC95%:0,02-0,24) showed correlation between CARG score and presented toxicities, considering low risk = I degree; Intermediary risk = II degree; High risk = III and IV degrees. Measurements of HGS using handgrip found medium values of 21,79kgf to Men and 15,26kgf to Women, considered inferior values when compared to non-oncologic aged patients. The association of CARG score to intermediary/high risk versus low risk+ HSG+ gender+ age showed through logistic regression to increase the accuracy of CARG score (AUC = 074). Conclusion: The performed CARG score showed agreement to toxicities demonstrated by patients and association of HGS+gender+age increased the accuracy of CARG score to predict toxicities of intermediary and high risks, considered able to impair the routine of life of elderly patients with cancer.

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
23 October 2019