title: Physical function and quality of life in frail and/or elderly patients with metastatic colorectal cancer treated with capecitabine and bevacizumab: an exploratory analysis.
abstract: OBJECTIVE
  Optimal treatment strategies in frail and/or elderly patients with metastatic colorectal cancer have not been well defined. Using data from a prospective, phase II study of elderly patients with metastatic colorectal cancer treated with bevacizumab and capecitabine, we explored the differences in functional measure and quality of life (QoL) between patients with ECOG performance status (PS) 1 and 2.
  
  
  METHODS
  Geriatric functional measures included patient reported limitations in ADLs and IADLs, ECOG PS, 3-item recall, hearing acuity, and the "Get up and Go" test. QoL was assessed by means of the FACT-C questionnaire and the EQ-5D questionnaire. The prognostic impact of baseline characteristics on survival was studied using univariate Cox regression analysis.
  
  
  RESULTS
  The majority (62%) of the 45 patients had an ECOG PS of 2. The ECOG PS 2 group had more limitations in IADLs, lower baseline QoL, and a lower patient-rated health score. For all participants, QoL significantly improved from baseline to the start of cycle 2 (FACT-C: 99.9 vs. 105.4, p=0.01) and did not deteriorate when baseline scores were compared to when participants went off study (FACT-C: 99.9 vs. 98.6, p=0.59). In the Cox-regression analysis, a positive "Get up and Go" test was prognostic for improved survival (HR=0.31, p=0.01).
  
  
  CONCLUSIONS
  There is significant heterogeneity in functional measures and quality of life among elderly patients with metastatic colorectal cancer with ECOG PS 1 and 2. The "Get up and Go" test may be a useful prognostic indicator for survival in this population.
authors.affiliation: David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, CA.
authors.forename: Peter
authors.initials: P
authors.lastname: Ward
authors.affiliation: David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, CA.
authors.forename: J Randolph
authors.initials: JR
authors.lastname: Hecht
authors.affiliation: David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, CA.
authors.forename: He-Jing
authors.initials: HJ
authors.lastname: Wang
authors.affiliation: Translational Oncology Research International (TORI), Santa Maria, CA.
authors.forename: Richard
authors.initials: R
authors.lastname: Dichmann
authors.affiliation: TORI, Long Beach, CA.
authors.forename: Andre K D
authors.initials: AK
authors.lastname: Liem
authors.affiliation: TORI, Redondo Beach, CA.
authors.forename: David
authors.initials: D
authors.lastname: Chan
authors.affiliation: TORI, Bakersfield, CA.
authors.forename: Ravi
authors.initials: R
authors.lastname: Patel
authors.affiliation: TORI, Alhambra, CA.
authors.forename: Edward H L
authors.initials: EH
authors.lastname: Hu
authors.affiliation: TORI, Long Beach, CA.
authors.forename: Neres S
authors.initials: NS
authors.lastname: Tchekmedyian
authors.affiliation: David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, CA.
authors.forename: Zev A
authors.initials: ZA
authors.lastname: Wainberg
authors.affiliation: David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, CA.
authors.forename: Arash
authors.initials: A
authors.lastname: Naeim
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000068258:Bevacizumab; D002140:California / Q000453:epidemiology; D000069287:Capecitabine; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology*; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016330:Frail Elderly / Q000706:statistics & numerical data; D015577:Geriatric Assessment / Q000379:methods / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000068258:Bevacizumab; D000069287:Capecitabine; D005472:Fluorouracil
keywords: Colon cancer; Colorectal cancer; Elderly; Frail; Metastatic; Performance status; Physical function; Quality of life; Toxicity