Impaired Geriatric 8 Score is Associated with Worse Survival after Radiotherapy in Older Patients with Cancer

J.G. Middelburg; R.A. Middelburg; M. van Zwienen; M.E. Mast; A. Bhawanie; J.J. Jobsen; T. Rozema; H. Maas; E.D. Geijsen; A.H. van der Leest; D.H.J.G. van den Bongard; J. van Loon; T. Budiharto; M.J. Aarts; C.H.J. Terhaard; H. Struikmans; LPRO (Dutch National Organization for Radiotherapy in the Elderly)

doi:10.1016/j.clon.2020.09.002

Impaired Geriatric 8 Score is Associated with Worse Survival after Radiotherapy in Older Patients with Cancer

J.G. Middelburg^*, R.A. Middelburg^*, M. van Zwienen, M.E. Mast, A. Bhawanie, J.J. Jobsen, T. Rozema, H. Maas, E.D. Geijsen, A.H. van der Leest, D.H.J.G. van den Bongard, J. van Loon, T. Budiharto, M.J. Aarts, C.H.J. Terhaard, H. Struikmans, LPRO (Dutch National Organization for Radiotherapy in the Elderly)

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Aims: To investigate whether the Geriatric 8 (G8) score and the Timed Get Up and Go Test (TGUGT), together with clinical and demographic patient characteristics, are associated with survival and late toxicity after (chemo)radiation therapy, administered with curative intent in older patients with cancer.

Materials and methods: Four hundred and two patients aged similar to 65 years (median age 72 years, range 65-96 years), diagnosed with either breast, non-small cell lung, prostate, head and neck, rectal or oesophageal cancer, and referred for curative (chemo)radiation therapy, took part in a multicentre prospective cohort study in eight radiotherapy centres in the Netherlands. The G8 and TGUGT scores were assessed before starting treatment. Other potential predictors and late toxicity were also recorded. Survival status and date of death, if applicable, were ascertained at the Dutch national death registry.

Results: After 2.5 years, the overall survival was 83%. Survival was 87% for patients with high G8 scores and 55% for patients with low G8 scores (Log-rank P value < 0.0001). Survival was 77% for patients with good TGUGT results and 50% for patients with poor TGUGT results (Log-rank P value < 0.001). In multi-variable analysis, in addition to age and type of primary tumour, the association of the G8 score with overall survival remained, with a hazard ratio of 2.1 (95% confidence interval 1.2-3.8) for low versus high scores.

Conclusions: G8 was associated with overall survival in older patients with cancer irradiated with curative intent. This association was independent of the predictive value of age and primary tumour. (C) 2020 The Royal College of Radiologists. Published by Elsevier Ltd.

Original language	English
Pages (from-to)	E203-E210
Number of pages	8
Journal	Clinical Oncology
Volume	33
Issue number	4
DOIs	https://doi.org/10.1016/j.clon.2020.09.002
Publication status	Published - 1 Apr 2021

Keywords

Cancer
elderly
G8
radiotherapy
survival
TGUGT

Access to Document

10.1016/j.clon.2020.09.002Licence: CC BY

Cite this

Middelburg, J. G., Middelburg, R. A., van Zwienen, M., Mast, M. E., Bhawanie, A., Jobsen, J. J., Rozema, T., Maas, H., Geijsen, E. D., van der Leest, A. H., van den Bongard, D. H. J. G., van Loon, J., Budiharto, T., Aarts, M. J., Terhaard, C. H. J., Struikmans, H., & LPRO (Dutch National Organization for Radiotherapy in the Elderly) (2021). Impaired Geriatric 8 Score is Associated with Worse Survival after Radiotherapy in Older Patients with Cancer. Clinical Oncology, 33(4), E203-E210. https://doi.org/10.1016/j.clon.2020.09.002

@article{bb911fc9261d4efd97ee0b29b67b6a3d,

title = "Impaired Geriatric 8 Score is Associated with Worse Survival after Radiotherapy in Older Patients with Cancer",

abstract = "Aims: To investigate whether the Geriatric 8 (G8) score and the Timed Get Up and Go Test (TGUGT), together with clinical and demographic patient characteristics, are associated with survival and late toxicity after (chemo)radiation therapy, administered with curative intent in older patients with cancer.Materials and methods: Four hundred and two patients aged similar to 65 years (median age 72 years, range 65-96 years), diagnosed with either breast, non-small cell lung, prostate, head and neck, rectal or oesophageal cancer, and referred for curative (chemo)radiation therapy, took part in a multicentre prospective cohort study in eight radiotherapy centres in the Netherlands. The G8 and TGUGT scores were assessed before starting treatment. Other potential predictors and late toxicity were also recorded. Survival status and date of death, if applicable, were ascertained at the Dutch national death registry.Results: After 2.5 years, the overall survival was 83%. Survival was 87% for patients with high G8 scores and 55% for patients with low G8 scores (Log-rank P value < 0.0001). Survival was 77% for patients with good TGUGT results and 50% for patients with poor TGUGT results (Log-rank P value < 0.001). In multi-variable analysis, in addition to age and type of primary tumour, the association of the G8 score with overall survival remained, with a hazard ratio of 2.1 (95% confidence interval 1.2-3.8) for low versus high scores.Conclusions: G8 was associated with overall survival in older patients with cancer irradiated with curative intent. This association was independent of the predictive value of age and primary tumour. (C) 2020 The Royal College of Radiologists. Published by Elsevier Ltd.",

keywords = "Cancer, elderly, G8, radiotherapy, survival, TGUGT",

author = "J.G. Middelburg and R.A. Middelburg and {van Zwienen}, M. and M.E. Mast and A. Bhawanie and J.J. Jobsen and T. Rozema and H. Maas and E.D. Geijsen and {van der Leest}, A.H. and {van den Bongard}, D.H.J.G. and {van Loon}, J. and T. Budiharto and M.J. Aarts and C.H.J. Terhaard and H. Struikmans and {LPRO (Dutch National Organization for Radiotherapy in the Elderly)}",

year = "2021",

month = apr,

day = "1",

doi = "10.1016/j.clon.2020.09.002",

language = "English",

volume = "33",

pages = "E203--E210",

journal = "Clinical Oncology",

issn = "0936-6555",

publisher = "Elsevier Science",

number = "4",

}

Middelburg, JG, Middelburg, RA, van Zwienen, M, Mast, ME, Bhawanie, A, Jobsen, JJ, Rozema, T, Maas, H, Geijsen, ED, van der Leest, AH, van den Bongard, DHJG, van Loon, J, Budiharto, T, Aarts, MJ, Terhaard, CHJ, Struikmans, H & LPRO (Dutch National Organization for Radiotherapy in the Elderly) 2021, 'Impaired Geriatric 8 Score is Associated with Worse Survival after Radiotherapy in Older Patients with Cancer', Clinical Oncology, vol. 33, no. 4, pp. E203-E210. https://doi.org/10.1016/j.clon.2020.09.002

TY - JOUR

T1 - Impaired Geriatric 8 Score is Associated with Worse Survival after Radiotherapy in Older Patients with Cancer

AU - Middelburg, J.G.

AU - Middelburg, R.A.

AU - van Zwienen, M.

AU - Mast, M.E.

AU - Bhawanie, A.

AU - Jobsen, J.J.

AU - Rozema, T.

AU - Maas, H.

AU - Geijsen, E.D.

AU - van der Leest, A.H.

AU - van den Bongard, D.H.J.G.

AU - van Loon, J.

AU - Budiharto, T.

AU - Aarts, M.J.

AU - Terhaard, C.H.J.

AU - Struikmans, H.

AU - LPRO (Dutch National Organization for Radiotherapy in the Elderly)

PY - 2021/4/1

Y1 - 2021/4/1

N2 - Aims: To investigate whether the Geriatric 8 (G8) score and the Timed Get Up and Go Test (TGUGT), together with clinical and demographic patient characteristics, are associated with survival and late toxicity after (chemo)radiation therapy, administered with curative intent in older patients with cancer.Materials and methods: Four hundred and two patients aged similar to 65 years (median age 72 years, range 65-96 years), diagnosed with either breast, non-small cell lung, prostate, head and neck, rectal or oesophageal cancer, and referred for curative (chemo)radiation therapy, took part in a multicentre prospective cohort study in eight radiotherapy centres in the Netherlands. The G8 and TGUGT scores were assessed before starting treatment. Other potential predictors and late toxicity were also recorded. Survival status and date of death, if applicable, were ascertained at the Dutch national death registry.Results: After 2.5 years, the overall survival was 83%. Survival was 87% for patients with high G8 scores and 55% for patients with low G8 scores (Log-rank P value < 0.0001). Survival was 77% for patients with good TGUGT results and 50% for patients with poor TGUGT results (Log-rank P value < 0.001). In multi-variable analysis, in addition to age and type of primary tumour, the association of the G8 score with overall survival remained, with a hazard ratio of 2.1 (95% confidence interval 1.2-3.8) for low versus high scores.Conclusions: G8 was associated with overall survival in older patients with cancer irradiated with curative intent. This association was independent of the predictive value of age and primary tumour. (C) 2020 The Royal College of Radiologists. Published by Elsevier Ltd.

AB - Aims: To investigate whether the Geriatric 8 (G8) score and the Timed Get Up and Go Test (TGUGT), together with clinical and demographic patient characteristics, are associated with survival and late toxicity after (chemo)radiation therapy, administered with curative intent in older patients with cancer.Materials and methods: Four hundred and two patients aged similar to 65 years (median age 72 years, range 65-96 years), diagnosed with either breast, non-small cell lung, prostate, head and neck, rectal or oesophageal cancer, and referred for curative (chemo)radiation therapy, took part in a multicentre prospective cohort study in eight radiotherapy centres in the Netherlands. The G8 and TGUGT scores were assessed before starting treatment. Other potential predictors and late toxicity were also recorded. Survival status and date of death, if applicable, were ascertained at the Dutch national death registry.Results: After 2.5 years, the overall survival was 83%. Survival was 87% for patients with high G8 scores and 55% for patients with low G8 scores (Log-rank P value < 0.0001). Survival was 77% for patients with good TGUGT results and 50% for patients with poor TGUGT results (Log-rank P value < 0.001). In multi-variable analysis, in addition to age and type of primary tumour, the association of the G8 score with overall survival remained, with a hazard ratio of 2.1 (95% confidence interval 1.2-3.8) for low versus high scores.Conclusions: G8 was associated with overall survival in older patients with cancer irradiated with curative intent. This association was independent of the predictive value of age and primary tumour. (C) 2020 The Royal College of Radiologists. Published by Elsevier Ltd.

KW - Cancer

KW - elderly

KW - G8

KW - radiotherapy

KW - survival

KW - TGUGT

U2 - 10.1016/j.clon.2020.09.002

DO - 10.1016/j.clon.2020.09.002

M3 - Article

C2 - 32972801

SN - 0936-6555

VL - 33

SP - E203-E210

JO - Clinical Oncology

JF - Clinical Oncology

IS - 4

ER -