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G-8 indicates overall and quality-adjusted survival in older head and neck cancer patients treated with curative radiochemotherapy

(2015) BMC CANCER. 15.
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Abstract
Background: Evidence-based guidelines concerning the older head and neck cancer (HNCA) patient are lacking. Accurate patient selection for optimal care management is therefore challenging. We examined if geriatric assessment is indicative of long-term health-related quality of life (HRQOL) and overall survival in this unique population. Methods: All HNCA patients, aged >= 65 years, eligible for curative radio(chemo) therapy were evaluated with the Geriatric-8 (G-8) questionnaire and a comprehensive geriatric assessment (CGA). Euroqol-5 dimensions (EQ-5D) and survival were collected until 36 months post treatment start. Repeated measures ANOVA was applied to analyse HRQOL evolution in 'fit' and 'vulnerable' patients, defined by G-8. Kaplan-Meier curves and cox proportional hazard analysis were established for determination of the prognostic value of geriatric assessments. Quality-adjusted survival was calculated in both patient subgroups. Results: One hundred patients were recruited. Seventy-two percent of patients were considered vulnerable according to CGA (>= 2 abnormal tests). Fit patients maintained a relatively acceptable long-term HRQOL, whilst vulnerable patients showed significantly lower median health states. The difference remained apparent at 36 months. Vulnerability, as classified by G-8 or CGA, came forward as independent predictor for lower EQ-5D index scores. After consideration of confounders, a significantly lower survival was observed in patients defined vulnerable according to G-8, compared to fit patients. A similar trend was seen based on CGA. Calculation of quality-adjusted survival showed significantly less remaining life months in perfect health in vulnerable patients, compared to fit ones. Conclusions: G-8 is indicative of quality-adjusted survival, and should be considered at time of treatment decisions for the older HNCA patient.
Keywords
Head and neck cancer, Geriatric assessment, Older patient, EuroQol-5 dimensions, Long-term quality of life, Curative treatment, Quality-adjusted survival, COMPREHENSIVE GERIATRIC ASSESSMENT, VULNERABLE ELDERS SURVEY-13, OF-LIFE, SCREENING TOOL, EUROPEAN-ORGANIZATION, INTERNATIONAL-SOCIETY, CONCURRENT CHEMORADIATION, OROPHARYNGEAL CANCER, RADIATION-THERAPY, FUNCTIONAL STATUS

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MLA
Pottel, Lies et al. “G-8 Indicates Overall and Quality-adjusted Survival in Older Head and Neck Cancer Patients Treated with Curative Radiochemotherapy.” BMC CANCER 15 (2015): n. pag. Print.
APA
Pottel, L., Lycke, M., Boterberg, T., Pottel, H., Goethals, L., Duprez, F., Rottey, S., et al. (2015). G-8 indicates overall and quality-adjusted survival in older head and neck cancer patients treated with curative radiochemotherapy. BMC CANCER, 15.
Chicago author-date
Pottel, Lies, Michelle Lycke, Tom Boterberg, Hans Pottel, Laurence Goethals, Fréderic Duprez, Sylvie Rottey, et al. 2015. “G-8 Indicates Overall and Quality-adjusted Survival in Older Head and Neck Cancer Patients Treated with Curative Radiochemotherapy.” Bmc Cancer 15.
Chicago author-date (all authors)
Pottel, Lies, Michelle Lycke, Tom Boterberg, Hans Pottel, Laurence Goethals, Fréderic Duprez, Sylvie Rottey, Yolande Lievens, Nele Van Den Noortgate, Kurt Geldhof, Véronique Buyse, Khalil Kargar-Samani, Véronique Ghekiere, and Philip Debruyne. 2015. “G-8 Indicates Overall and Quality-adjusted Survival in Older Head and Neck Cancer Patients Treated with Curative Radiochemotherapy.” Bmc Cancer 15.
Vancouver
1.
Pottel L, Lycke M, Boterberg T, Pottel H, Goethals L, Duprez F, et al. G-8 indicates overall and quality-adjusted survival in older head and neck cancer patients treated with curative radiochemotherapy. BMC CANCER. 2015;15.
IEEE
[1]
L. Pottel et al., “G-8 indicates overall and quality-adjusted survival in older head and neck cancer patients treated with curative radiochemotherapy,” BMC CANCER, vol. 15, 2015.
@article{7017228,
  abstract     = {Background: Evidence-based guidelines concerning the older head and neck cancer (HNCA) patient are lacking. Accurate patient selection for optimal care management is therefore challenging. We examined if geriatric assessment is indicative of long-term health-related quality of life (HRQOL) and overall survival in this unique population. 
Methods: All HNCA patients, aged >= 65 years, eligible for curative radio(chemo) therapy were evaluated with the Geriatric-8 (G-8) questionnaire and a comprehensive geriatric assessment (CGA). Euroqol-5 dimensions (EQ-5D) and survival were collected until 36 months post treatment start. Repeated measures ANOVA was applied to analyse HRQOL evolution in 'fit' and 'vulnerable' patients, defined by G-8. Kaplan-Meier curves and cox proportional hazard analysis were established for determination of the prognostic value of geriatric assessments. Quality-adjusted survival was calculated in both patient subgroups. 
Results: One hundred patients were recruited. Seventy-two percent of patients were considered vulnerable according to CGA (>= 2 abnormal tests). Fit patients maintained a relatively acceptable long-term HRQOL, whilst vulnerable patients showed significantly lower median health states. The difference remained apparent at 36 months. Vulnerability, as classified by G-8 or CGA, came forward as independent predictor for lower EQ-5D index scores. After consideration of confounders, a significantly lower survival was observed in patients defined vulnerable according to G-8, compared to fit patients. A similar trend was seen based on CGA. Calculation of quality-adjusted survival showed significantly less remaining life months in perfect health in vulnerable patients, compared to fit ones. 
Conclusions: G-8 is indicative of quality-adjusted survival, and should be considered at time of treatment decisions for the older HNCA patient.},
  articleno    = {875},
  author       = {Pottel, Lies and Lycke, Michelle and Boterberg, Tom and Pottel, Hans and Goethals, Laurence and Duprez, Fréderic and Rottey, Sylvie and Lievens, Yolande and Van Den Noortgate, Nele and Geldhof, Kurt and Buyse, Véronique and Kargar-Samani, Khalil and Ghekiere, Véronique and Debruyne, Philip},
  issn         = {1471-2407},
  journal      = {BMC CANCER},
  keywords     = {Head and neck cancer,Geriatric assessment,Older patient,EuroQol-5 dimensions,Long-term quality of life,Curative treatment,Quality-adjusted survival,COMPREHENSIVE GERIATRIC ASSESSMENT,VULNERABLE ELDERS SURVEY-13,OF-LIFE,SCREENING TOOL,EUROPEAN-ORGANIZATION,INTERNATIONAL-SOCIETY,CONCURRENT CHEMORADIATION,OROPHARYNGEAL CANCER,RADIATION-THERAPY,FUNCTIONAL STATUS},
  language     = {eng},
  pages        = {11},
  title        = {G-8 indicates overall and quality-adjusted survival in older head and neck cancer patients treated with curative radiochemotherapy},
  url          = {http://dx.doi.org/10.1186/s12885-015-1800-1},
  volume       = {15},
  year         = {2015},
}

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