Survey Predicts Tolerance to Chemotherapy for Older Patients

The answers to eleven questions help individuals aged 65 years and older determine the risk of a severe to potentially fatal reaction to chemotherapy

By Christine Gorman

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The elderly—especially the very old—are the fastest-growing group of cancer patients in the U.S., according to an article written by Claudia Wallis in the December 2014 Scientific American. Determining which older patients can benefit from chemotherapy—and which ones lack the resilience to tolerate it—have therefore become increasingly urgent issues.

Arti Hurria of the City of Hope Comprehensive Cancer Center in Duarte, Calif., and colleagues have devised and tested a tool for determining chemotherapy tolerance in older patients. “It’s 11 questions and it’s not hard to do,” says Hurria, who just completed a two-year term as president of the International Society of Geriatric Oncology.

The questions and the scoring for each response appear below.

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Risk Factor	Score
Age 72 or greater	2
Cancer type: gastrointestinal or genitourinary	2
Chemotherapy dosing: standard dose	2
More than one chemotherapy drug	2
Hemoglobin less than 11 grams per deciliter for males or less than 10 grams per deciliter for females	3
Creatine clearance (Jelliffe formula—ideal weight): less than 34 milliliters per minute	3
Hearing: described as fair or worse	2
Number of falls in past six months: one or more	3
Needs assistance with taking medications	1
Limited in walking one block	2
Decreased social activity because of physical or emotional health	1

A score of 0 to 5 means the patient has a low risk of experiencing severe toxicity from chemotherapy, 6 to 9 indicates about a 50 percent risk and 10 to 19 indicates a high risk of developing a severe or even fatal reaction to chemotherapy.

To learn more about the research behind this 11-question survey, click here.

A more detailed geriatric assessment can be found here, courtesy of the Cancer and Aging Research Group.

Source: "Predicting Chemotherapy Toxicity in Older Adults with Cancer: A Prospective Multicenter Study," by Arti Hurria et al in Journal of Clinical Oncology; Vol. 29, Issue 25, pages 3457–346. September 1, 2011.

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