Nutzen verschiedener geriatrischer Assessments zur Prädiktion gesundheitsrelevanter Endpunkte - eine Untersuchung an Patientinnen mit Mammakarzinom

Abstract

Many studies have shown that elderly women with breast carcinoma are often undertreated. The aim of this study was to find a geriatric assessment that can predict the toxicity and fatigue of the adjuvant therapy as well as the quality of life and disability of the women after chemotherapy or radiotherapy. 82 women, between 65 and 86 years old, with breast carcinoma, treated in the University of Ulm between February 2008 and January 2010 with an adjuvant therapy, were included in the study. The question was if selected geriatric assessments could predict the fatigue and toxicity (evaluated with the Common Toxicity Criteria and the FACT-An) as primary endpoints and the quality of life and disabilty after the therapy (evaluated with the EORTC-QLQ-C30 and the SF-LLFDI) as secondary endpoints. Assessments were conducted before adjuvant treatment and after radiotherapy. The assessments included the Vulnerable Elders Survey-13 (VES-13), the Karnofsky Performance Status (KPS), the EORTC Quality of Life assessment (EORTC-QLQ-C30), the Hurria comprehensive geriatric assessment (Hurria-CGA), the Fried frailty score, the gait speed, the clock-drawing test, the handgrip strength and the WHO-quality of life assessment for older people (WHO-QOL-OLD). 14 patients (17 %) were assessed after chemotherapy, 59 patients (72 %) after radiotherapy and 9 patients (11 %) both after chemotherapy and radiotherapy. The Karnofsky Perfomance Status and the EORTC-QLQ-C30 showed significant associations to both outcomes in our study. The Hurria-CGA is associated with the quality of life and disability of the patients after adjuvant therapy. These assessments can help to guide treatment decisions among older oncology patients. The VES-13, the Fried frailty score, the WHO-QOL-OLD, the gait speed, the handgrip strength and the clock-drawing test could not predict adequately the toxicity and quality of life of the patients.