Predictors of chemotherapy tolerance and survival benefit in a geriatric patient population with advanced solid tumors.

ABSTRACT

BACKGROUND: It is challenging to identify robust elderly patients suitable for systemic chemotherapy. The goal of this study was to ascertain clinical characteristics that may best predict the most benefit of systemic chemotherapy for geriatric patients (aged ≥80 years) with advanced solid tumors. METHODS: A retrospective cohort study was conducted of advanced solid tumors patients treated with systemic chemotherapy. We divided the patients into chemotherapy tolerant and intolerant groups. We assessed the efficacy, adverse reactions, progression-free survival, and overall survival of patients treated with chemotherapy. We accounted for comorbidities, Eastern Cooperative Oncology Group performance status (PS), activities of daily living (ADL), and routine serologic lab metrics. We compiled survival curves for the two groups, and Cox regression univariate and multivariate analyses were used to identify factors that influenced survival. RESULTS: We included 84 patients in the analyses. Comorbidities ≤3, medications ≤4, ADL score ≥90, and PS score ≤1 were associated with chemotherapy tolerance (P < 0.05). Normal D-Dimer and serum albumin concentrations were associated with chemotherapy tolerance (P < 0.05). The median overall survival was 15.0 months (95% confidence interval [CI] 12.8 - 17.2) in the tolerant group and 7.0 months (95% CI 4.3 - 9.7) in the intolerant group (P < 0.05). Thus, most tolerant patients (79.6%) benefited from chemotherapy. PS, ADL, normal albumin, and chemotherapy tolerance were statistically correlated with overall survival (P < 0.05). CONCLUSION: Some clinical characteristics were associated with chemotherapy tolerance. The overall survival time of elderly patients with good tolerance to chemotherapy was longer.