Research Square · Apr 15, 2022
The utility of G8 screening for clinical practice of chemotherapy in older patients with gastrointestinal cancer
By Doi A, Mizukami T, Takeda H et al.
Abstract Background:Geriatric 8 (G8) is a useful screening tool for geriatric assessment for predicting survival or risk of serious adverse events (SAEs) in older cancer patients. However, the clinical utility of G8 is not well known in older patients with gastrointestinal (GI) cancer developing malnutrition. We investigated the association between G8 score and clinical outcomes in older patients with GI cancer.Methods: We retrospectively registered patients with GI cancer aged ≥65 years who received a G8 questionnaire at first visit from April 2018 to March 2020. The G8 score, SAE, dose reduction rate, discontinuation rate, and overall survival (OS) were evaluated. Safety was assessed in all patients and OS in GI cancer patients with unresectable tumors.Results:In a total of 207 patients (median age: 75, range: 65–92, 56% of unresectable cancer), the median G8 score was 10.5 and the percentage of normal G8 score was only 6.8%. There was no clear association between G8 score and OS or SAEs in 143 (69%) patients received chemotherapy (CT). However, the median G8 score was significantly higher in patients with CT compared to those without CT (11.5 vs 10.0 months, p < 0.0001). One-hundred seven of 129 (83%) older patients with abnormal G8 score were treated with CT by treatment modification such as dose reduction, and they had no unexpected SAEs and better prognosis than those without CT. The rate of normal instrumental activity of daily life (IADL) was significantly higher in patients with CT compared to those without CT (64% vs. 23%, p < 0.0001). In addition, there was a significant difference in OS according to IADL even in patients with abnormal G8 score.Conclusions:There was no association between G8 score and OS or SAE in older patients with GI cancer; however, most patients with abnormal G8 score could receive CT safely and effectively through treatment modification. The IADL may be clinically useful to predict prognosis and determine the treatment plan for older patients.