Geriatric impairments hurt QoL, physical function in older cancer patients

Among older patients with cancer, geriatric impairments appear to have a strong negative impact on quality of life (QoL) and physical function (PF), reports a recent study. However, radiotherapy (RT) appears to be well-tolerated in this group.

Researchers conducted a prospective observational study of 301 cancer patients aged ≥65 years, of whom 53.8 percent were receiving curative intent RT, while the rest were undergoing palliative RT. Geriatric assessment was performed before RT. The primary outcomes, global QoL and PF, were evaluated using The European Organisation for Research and Treatment of Cancer Quality-of-Life Core Questionnaire (EORTC QLQ-C30).

Of the participants, 22.7 percent had one GA impairment, while 16.9 percent, 16.3 percent, and 27.5 percent had 2, 3, and ≥4 impairments, respectively. In comparison, 16.6 percent had no GA impairments. QoL, PF, pain, and fatigue were significantly better among those receiving curative vs palliative RT.

Global QoL scores progressively worsened with an increasing number of GA impairments. Those with no such impairments had a mean global score of 81.6, which dropped to 51.5 in participants with ≥4 impairments. A similar effect was reported for PF (90.7 to 43.4), as well as role function (90.1 to 34.8).

Fatigue, pain, dyspnoea, and insomnia, among other symptoms, also worsened with an increasing number of geriatric impairments.

Of note, “RT did not significantly influence patients’ perceived global QoL and functioning,” the researchers said. “This suggests that existing impairments should not be seen as contraindications for RT per se.”