title: Timed Get Up and Go Test and Geriatric 8 Scores and the Association With (Chemo-)Radiation Therapy Noncompliance and Acute Toxicity in Elderly Cancer Patients.
abstract: To investigate whether the Geriatric 8 (G8) and the Timed Get Up and Go Test (TGUGT) and clinical and demographic patient characteristics were associated with acute toxicity of radiation therapy and noncompliance in elderly cancer patients being irradiated with curative intent.
  
  
  
  Patients were eligible if aged ≥65 years and diagnosed with breast, non-small cell lung, prostate, head and neck, rectal, or esophageal cancer, and were referred for curative radiation therapy. We recorded acute toxicity and noncompliance and identified potential predictors, including the G8 and TGUGT.
  
  
  
  We investigated 402 patients with a median age of 72 years (range, 65-96 years). According to the G8, 44.4% of the patients were frail. Toxicity grade ≥3 was observed in 22% of patients who were frail according to the G8 and 9.1% of patients who were not frail. The difference was 13% (confidence interval 5.2%-20%; P=.0006). According to the TGUGT 18.8% of the patients were frail; 21% of the frail according to the TGUGT developed toxicity grade ≥3, compared with 13% who were not frail. The difference was 7.3% (confidence interval -2.7% to 17%; P=.11). Overall compliance was 95%. Toxicity was most strongly associated with type of primary tumor, chemotherapy, age, and World Health Organization performance status. Compliance was associated with type of primary tumor and age.
  
  
  
  The usefulness of the TGUGT and G8 score in daily practice seems to be limited. Type of primary tumor, chemoradiotherapy, age, and World Health Organization performance status were more strongly associated with acute toxicity. Only chemoradiotherapy and age were associated with noncompliance. Overall the compliance was very high. To allow better-informed treatment decisions, a more accurate prediction of toxicity is desirable.
authors.affiliation: Radiotherapy, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: j.middelburg-vanrijn@erasmusmc.nl.
authors.forename: Judith G
authors.initials: JG
authors.lastname: Middelburg
authors.affiliation: Department of Radiotherapy, Haaglanden Medical Center, The Hague, The Netherlands.
authors.forename: Mirjam E
authors.initials: ME
authors.lastname: Mast
authors.affiliation: Radiotherapy, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Maaike
authors.initials: M
authors.lastname: de Kroon
authors.affiliation: Radiation Oncology, Medisch Spectrum Twente, Enschede, The Netherlands.
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Jobsen
authors.affiliation: Radiotherapy, Institute Verbeeten, Tilburg, The Netherlands.
authors.forename: Tom
authors.initials: T
authors.lastname: Rozema
authors.affiliation: Geriatrics, Tweesteden Hospital, Tilburg, The Netherlands.
authors.forename: Huub
authors.initials: H
authors.lastname: Maas
authors.affiliation: Radiotherapy, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Elizabet A
authors.initials: EA
authors.lastname: Baartman
authors.affiliation: Radiotherapy, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Debby
authors.initials: D
authors.lastname: Geijsen
authors.affiliation: Radiotherapy, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Annija H
authors.initials: AH
authors.lastname: van der Leest
authors.affiliation: Department of Radiotherapy, University Medical Centre, Utrecht, The Netherlands.
authors.forename: Desirée J
authors.initials: DJ
authors.lastname: van den Bongard
authors.affiliation: Department of Radiation Oncology (Maastro Clinic), GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Judith
authors.initials: J
authors.lastname: van Loon
authors.affiliation: Department of Radiotherapy, Catharina Ziekenhuis, Eindhoven, The Netherlands.
authors.forename: Tom
authors.initials: T
authors.lastname: Budiharto
authors.affiliation: Public Health, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Jan Willem
authors.initials: JW
authors.lastname: Coebergh
authors.affiliation: Netherlands Cancer Registry, Netherlands Comprehensive Cancer Organization, Utrecht, The Netherlands.
authors.forename: Mieke J
authors.initials: MJ
authors.lastname: Aarts
authors.affiliation: Department of Radiotherapy, Haaglanden Medical Center, The Hague, The Netherlands.
authors.forename: Henk
authors.initials: H
authors.lastname: Struikmans
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000970:Antineoplastic Agents / Q000009:adverse effects; D001943:Breast Neoplasms / Q000628:therapy; D002289:Carcinoma, Non-Small-Cell Lung / Q000628:therapy; D059248:Chemoradiotherapy / Q000009:adverse effects* / Q000706:statistics & numerical data*; D016001:Confidence Intervals; D004938:Esophageal Neoplasms / Q000628:therapy; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D015577:Geriatric Assessment / Q000379:methods*; D006258:Head and Neck Neoplasms / Q000628:therapy; D006801:Humans; D008175:Lung Neoplasms / Q000628:therapy; D008297:Male; D009369:Neoplasms / Q000628:therapy*; D062072:Patient Acuity; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011471:Prostatic Neoplasms / Q000628:therapy; D012004:Rectal Neoplasms / Q000628:therapy
chemical_list: D000970:Antineoplastic Agents