title: Frailty and vulnerability as predictors of radiotoxicity in older adults: A longitudinal study in Peru.
abstract: OBJECTIVE
  To assess the association between frailty/vulnerability and the development of radiotoxicity in older adults at a hospital in Peru.
  
  
  METHODS
  Cohort study that included patients with cancer with medical recommendation of radiotherapy, who attended the outpatient department of geriatrics at Naval Medical Center (Lima, Peru) between 2013 and 2015. Before receiving radiation therapy sessions, we measured frailty using Fried phenotype, and vulnerability using VES-13 and G-8 scales. During radiotherapy, we determined the development of radiotoxicity. ROC curves and crude/adjusted Cox regression models were prepared to evaluate the association between the frailty/vulnerability scales and the development of radiotoxicity respectively.
  
  
  RESULTS
  From a total of 181 patients (mean age: 78.1 years, all males), 33 (18.2%) developed some type of radiotoxicity. The appearance of radiotoxicity was higher in patients with frailty or vulnerability compared with those without these conditions, according to the usual cutoff points of Fried phenotype (10.9% versus 41.9%), VES-13 (5.0% versus 63.4%) and G-8 (5.6% versus 67.6%). The area under the curve was 0.61 (0.55-0.65) for the Fried phenotype, 0.79 (0.69-0.86) for the VES-13, and 0.86 (0.58-0.89) for the G-8.
  
  
  CONCLUSIONS
  We found an association between frailty/vulnerability and the development of radiotoxicity. The G-8 and the VES-13 scales had a better area under the curve than Fried phenotype, suggesting that those could be useful tools when deciding the dose of radiotherapy in geriatric patients.
authors.affiliation: Centro de Investigación del Envejecimiento, Universidad de San Martín de Porres, Lima, Perú.
authors.forename: Fernando M
authors.initials: FM
authors.lastname: Runzer-Colmenares
authors.affiliation: Sociedad Científica de Estudiantes de Medicina de la Universidad de San Martín de Porres, Lima, Perú. Electronic address: diego.urrunaga.pastor1@gmail.com.
authors.forename: Diego
authors.initials: D
authors.lastname: Urrunaga-Pastor
authors.affiliation: Sociedad Científica de Estudiantes de Medicina de la Universidad de San Martín de Porres, Lima, Perú.
authors.forename: Luis G
authors.initials: LG
authors.lastname: Aguirre
authors.affiliation: Asociación para el Desarrollo de la Investigación Estudiantil en Ciencias de la Salud (ADIECS), Universidad Nacional Mayor de San Marcos, Lima, Perú.
authors.forename: C Mahony
authors.initials: CM
authors.lastname: Reategui-Rivera
authors.affiliation: Centro de Investigación del Envejecimiento, Universidad de San Martín de Porres, Lima, Perú.
authors.forename: José F
authors.initials: JF
authors.lastname: Parodi
authors.affiliation: Centro de Investigación del Envejecimiento, Universidad de San Martín de Porres, Lima, Perú.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Taype-Rondan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016330:Frail Elderly; D000073496:Frailty / Q000150:complications* / Q000175:diagnosis; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010568:Peru; D016016:Proportional Hazards Models; D012372:ROC Curve; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology*; D011878:Radiotherapy / Q000009:adverse effects*; D012307:Risk Factors
keywords: Anciano frágil; Cancer; Cáncer; Evaluación geriátrica; Frail elderly; Geriatric assessment; Radioterapia; Radiotherapy; Toxicidad; Toxicity