Comorbidity and functional status are independent in older cancer patients
Comorbidity and functional status are independent in older cancer patients
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DOI：
10.1200/jco.1998.16.4.1582
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发表时间：
1998-04-01
影响因子：
45.3
通讯作者：
Balducci, L
中科院分区：
文献类型：
--
作者：
Extermann, M;Overcash, J;Balducci, L
目的：合并症在老年癌症患者中很常见，并且常常是治疗上的限制问题，然而，迄今为止，还没有可用于这些患者的合并症负担的标准测量方法，我们测试了两种合并症量表的性能及其与功能状态的关系，患者和方法：将老年累积疾病评定量表（CIRS-G）与查尔森量表进行比较，其中 203 名患者接受了综合老年评估（CGA）我们的高级成人肿瘤学计划 (SAOP)，研究终点是变异性、可靠性、与东部肿瘤合作组 (ECOG) 表现状态 (PS)、日常生活活动 (ADL) 和工具性日常生活活动 (IADL) 的相关性。评估了合并症与肿瘤分期在功能状态相关性中的相对权重，结果：中位年龄为 75 岁（范围为 63 至 91），64% 的患者在 Charlson 量表上得分为 0，而在 CIRS-G 上得分为 6%，Charlson 和 CIRS-G 之间的相关性相当（p = 0.25 至 0.39）。 CIRS-G 3/4 级与 ADL 具有相当的相关性 (p = 0.27)，否则，各项指标的合并症与功能状态之间的相关性较低或没有相关性，肿瘤分期也与功能状态不相关。 ECOG PS 与 ADL（p = 0.51）和 IADL（p = 0.61）的相关性中等，Charlson 和 CIRS-G 的评分者和重测相关性良好或非常好，结论：合并症需要独立于功能状态进行评估，Charlson 和 CIRS-G 量表都是用于老年癌症患者试验的可靠工具，两者都可以在进一步的研究中作为结果的预测因子进行测试，例如治疗的毒性、功能状态的变化或生存率。 (C) 1998 年美国临床肿瘤学会。
Purpose: Comorbidity is ct frequent and often therapeutically limiting problem in older cancer patients, However, to date, there is no standard measure of the comorbidity burden available for these patients, We tested the performance of two comorbidity scales and their relationship with functional status,Patients and Methods: The Cumulative Illness Rating Scale-Geriatric (CIRS-G) was compared with the Charlson scale in 203 patients who received a comprehensive geriatric assessment (CGA) in our Senior Adult Oncology Program (SAOP), Study end points were variability, reliability, correlation with Eastern Cooperative Oncology Group (ECOG) performance status (PS), Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL). The relative weight of comorbidity versus tumor stage in the correlations with functional status was assessed,Results: Median age was 75 years (range, 63 to 91), Sixty-four percent of patients scored 0 on the Charlson scale versus 6% on the CIRS-G, The correlation between the Charlson and CIRS-G was fair (p = 0.25 to 0.39). CIRS-G grade 3/4 had a fair correlation with ADL (p = 0.27), Otherwise, there was low or no correlation between comorbidity and functional status across the measures, Tumor stage was not correlated with functional status either. Correlation of ECOG PS with ADL(p = 0.51) and IADL (p = 0.61) wets moderate, Interrater and test-retest correlations were good or very good for both the Charlson and CIRS-G,Conclusion: Comorbidity needs to be assessed independently from functional status, Both the Charlson and CIRS-G scales are reliable tools for use in trials of older cancer patients, Both can be tested in further studies as predictors of outcomes such as toxicity of treatment, changes in functional status, or survival. (C) 1998 by American Society of Clinical Oncology.