Author of

• 18718

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  P3.05 - Poster Session with Presenters Present (ID 475)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Palliative Care/Ethics
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/07/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 18723

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    P3.05-005 - Geriatric Assessment and Functional Decline in Older Patients with Lung Cancer (ID 4095)

    14:30 - 14:30  |  Author(s): H. Wildiers
    • Abstract

    Background:
    Physicians treating lung cancer are confronted with an expanding group of older patients. Treatment of these patients is complex and focusses on improving quality of life, maintenance of functional status (FS) and prolonging overall survival (OS). The present study aims to evaluate the role of geriatric assessment (GA) and the evolution of FS in older patients with lung cancer, and to identify predictors for functional decline and OS.
    
    Methods:
    Patients ≥70 years with a new diagnosis of lung cancer were included. At baseline, GA was performed, including FS measured by Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). ADL and IADL were reevaluated 2-3 months after diagnosis. OS was collected. Determination of predictors of functional decline on ADL and IADL and of OS was performed by univariate and multivariable logistic and Cox regression.
    
    Results:
    245 patients with a median age of 76 years were included from October 2009 till January 2015. The majority of patients (58%) had stage IV disease. Treatment consisted of surgery in 20 patients (8%), radiotherapy in 105 patients (43%) and chemotherapy or targeted therapy in 125 patients (51%). At baseline, GA deficiencies were observed in all domains, most prominent for comorbidities (78%), fatigue (76%) and nutrition (76%). 240 patients (98%) had at least 2/10 abnormal domains with a median of 5. ADL and IADL impairments were detected in 51% and 63% of patients respectively. Follow-up ADL and IADL data were available for 145 patients. Functional decline for ADL was observed in 23% (95%CI 16,2; 29,9) and for IADL in 45% (95%CI 36,9;53,1) of patients. In multivariable analysis, radiotherapy was predictive for ADL decline. No other predictive factors for ADL or IADL decline were identified. In multivariable Cox regression, stage, gender and age were predictive for survival .
    
    Conclusion:
    Older patients with lung cancer are a high risk population with deficiencies in multiple geriatric domains. During treatment functional decline is observed in half of the patients, more prominently for IADL. Functional decline on ADL at 2-3 months is predicted by radiotherapy, possibly related to the acute toxicities of this treatment. None of the specific domains of the GA nor cumulative deficits on GA were predictive for functional decline or survival. Further research should focus on the role of interventions on evolution of quality of life.