Yuliya Alekseeva
N.N. Petrov National Medical Research Centre, Russia FederationTitle: Assessment and correction of geriatric status in patients with metastatic colorectal cancer during first-line chemotherapy
Abstract
In Russia in
2020, the prevalence of colorectal cancer (CRC) in patients over 60 years of
age was 16.3%, mortality – 15.1%. The aim of the study is to increase the
efficiency and tolerability of the first-line chemotherapy of patients with
metastatic CRC (mCRC) in the elderly and senile age using assessment and correction
of geriatric syndromes (CGS).
The study included data on
180 patients with mCRC who received first-line chemotherapy: 62 patients according
to the «FOLFOX±Bev+CGS» scheme, and 118 patients according to the «FOLFOX±Bev
without CGS». The CGS was carried out by a multidisciplinary team of the
rehabilitation department. The frequency of geriatric syndromes (GS), objective
response (OR), clinically significant response (CSR: OR+stabilization),
event-free survival (EFS), and the toxic profile of chemotherapy were studied.
The most common GS in
elderly patients were cognitive deficiency – 70.7%; malnutrition syndrome (by
the MNA scale < 23.5 points) in 56.1% of patients, chronic pain syndrome in
51.2%, dependence on external assistance – 53.7%. During the CGS, the index of
cognitive function increased to ?27 points in 56% (p=0.01), the index of
nutritional status increased to 25.9 points (absence of malnutrition) in 85% of
patients (p<0.001); dependence on external assistance decreased by 23.7%
(p=0.035). Grade 3 neutropenia in the group «FOLFOX±Bev without CGS» was 11%
for elderly patients, and was completely absent in the group of patients with
CGS (p<0.05), anemia grade 1-3 developed in 82.5% vs. 56.1% (p<0.01); CSR
was better in the group "FOLFOX±Bev+CGS" – 91,9%; without CGS – 80,5%
(p<0.05); the median of EFS was higher in the group with CGS regardless of
age – 9.9 (8.84-11.08) months, without CGS – 7.2 (4.15-10.24) months, (p=0.02).
The CGS allows to improve
not only the geriatric status and tolerability of chemotherapy, but also the
direct results of treatment (CSR) and long-term results (EFS) in patients with
mCRC.
Biography
Yuliya
Alekseeva has completed her postgraduate studies in 2021. The theme of her
research is "Optimizing the treatment of patients with metastatic
colorectal cancer by assessing and correcting of the geriatric status".
She is an oncologist and a researcher at the Scientific Department of Innovative
Methods of Therapeutic Oncology and Rehabilitation at the N.N. Petrov National
Medical Research Center. She is the author of 41 publications and 2 patents for
the invention.
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