title: Pilot of three objective markers of physical health and chemotherapy toxicity in older adults.
abstract: BACKGROUND
  Patient function is a key part of the clinical decision to offer chemotherapy and has, in earlier studies, been associated with chemotherapy toxicity. Objective testing might be more accurate than patient-reported or physician-assessed physical function, and thus might be a stronger predictor of chemotherapy toxicity in older adults.
  
  
  METHODS
  Patients, 70 years of age and older, with thoracic or colorectal cancer were recruited. Three physical tests were performed before commencement of a new line of chemotherapy: grip strength, 4-m walk test, and the Timed Up and Go (tug). Our pilot study explored the association between those tests and chemotherapy toxicity.
  
  
  RESULTS
  The 24 patients recruited had a median age of 74.5 years (range: 70-84 years), and 54.2% had an Eastern Cooperative Oncology Group performance status of 0 or 1. Median score on the Charlson comorbidity index was 1 (range: 0-4). Almost two thirds had metastatic disease, 70% were chemonaïve, and 83.3% were about to receive polychemotherapy. Patients had a mean tug of 13.2 ± 5.7 s and a mean gait speed of 0.74 ± 0.24 m/s; 50% had a grip strength test in the lowest 20th percentile. Grades 3-5 chemotherapy toxicities occurred in 34.7% of the patients; two thirds required a dose reduction or delay; and one third discontinued chemotherapy because of toxicity. Hospitalization attributable to chemotherapy was uncommon (12.5%). A trend toward increased severe chemotherapy toxicity with slower gait speed was observed (p = 0.049).
  
  
  CONCLUSIONS
  Abnormalities in objective markers of physical function are common in older adults with cancer, even in those deemed fit for chemotherapy. However, those abnormalities were not associated with an increased likelihood of chemotherapy toxicity in the population included in this small pilot study.
authors.affiliation: University of Toronto, Toronto, ON;
authors.forename: T
authors.initials: T
authors.lastname: Hsu
authors.affiliation: University of Toronto, Toronto, ON;
authors.forename: R
authors.initials: R
authors.lastname: Chen
authors.affiliation: Department of Medical Oncology, Princess Margaret Cancer Centre, Toronto, ON;
authors.forename: S C X
authors.initials: SC
authors.lastname: Lin
authors.affiliation: Department of Medical Oncology, Princess Margaret Cancer Centre, Toronto, ON;
authors.forename: S
authors.initials: S
authors.lastname: Djalalov
authors.affiliation: Department of Medical Oncology, Princess Margaret Cancer Centre, Toronto, ON;
authors.forename: A
authors.initials: A
authors.lastname: Horgan
authors.affiliation: Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, ON.
authors.forename: L W
authors.initials: LW
authors.lastname: Le
authors.affiliation: Department of Medical Oncology, Princess Margaret Cancer Centre, Toronto, ON;
authors.forename: N
authors.initials: N
authors.lastname: Leighl
keywords: Aging; chemotherapy toxicity; elderly people; neoplasms; objective markers; older adults; physical health