1545O - Fatigue (F) and anemia scores for overall survival (OS) prognosis

Date 01 October 2012
Event ESMO Congress 2012
Session Supportive and palliative care
Topics Supportive Care
Presenter Reza-Thierry Elaidi
Authors Y. Gornadha1, R. Elaidi1, F. Scotte1, Y. Vano1, N. Pecuchet2, J. Gachet1, J. Medioni3, E. Fabre3, S. Oudard4
  • 1Oncology, hospital G.Pompidou, 75015 - paris/FR
  • 2Dept. Medical Oncology, GEORGES POMPIDOU HOSPITAL, FR-75908 - PARIS Cedex /FR
  • 3Medical Oncology, Georges Pompidou Hospital and Rene Descartes University, 75015 - Paris/FR
  • 4Medical Oncology Service, Georges Pompidou Hospital and Rene Descartes University, 75015 - Paris/FR

 

Abstract

Background

F is an adverse reaction related both to disease and treatment in cancer patients (pts). Incidence of F episodes and anemia could be expressed using scores which association with OS could be useful for treatment management.

Methods

Pts included in the PROCHE program between 2008 and 2011 at the HEGP hospital (Paris, France). Pts were contacted before each chemotherapy (CT), and F experienced since the last cycle was collected (patient's subjective scale PSS: 0 = none, 1 = mild, 2 = moderate, 3 = severe, 4 = 3 + long-term condition). Hb levels were also assessed at least once before each CT using the scale for Hb: 0: > 12, 1:]12-10], 2:]10-9], 3:]9-8], 4: < 8. Scores linear (mean) and non-linear (polynomial) were calculated using for F: grades from start to end CT and for anemia: mean grade per cycle. OS was calculated from CT initiation to death or censured at last contact.

Results

1279 pts entered the program, 662 (equivalent to 4327 CT cycles) had at least 1 assessment of (fatigue + Hb). Excluded pts (617) due to lacking Hb results did not differ from the 662 (log-Rank = 0.98). Median age = 64.9y, sex-ratio = 1.1, more frequent localization: lung (23%), breast (21%), prostate (13%), ovary (10%). 229 and 433 pts had respectively at least 1 or 2 Hb results at each cycle. There were 5376 episodes of fatigue in total (PSS > 0), 694 pts experienced at least 1 episode. 516, 232, 101 and 35 pts experienced at least 1 anemia episode on scale 1, 2, 3 and 4 respectively. Median linear F score = 1.08 [0-3], non-linear = 1.57 [0-200.7]. Median linear anemia score = 0.78 [0-1.5], non-linear = 0.78 [0-1.6]. OS was 24.8m IC95%|21.6-30.4]. Linear scores were normally distributed and non-linear were discarded since much skewed. As expected, anemia and fatigue were correlated (ANOVA, p < 0.0001). Linear F score (LFS) was good predictor of OS (L: HR = 2.5, IC95% [2.0-3.1], p < 0.0001). Patients with LFS > 2 (N = 72) had an increased death risk of 4.65 (IC95%|3.15-6.88]) with respect to LFS < 1 (N = 247). Hb mean and linear anemia score were good predictors for OS, respectively HR = 1.45 IC95% [1.31; 1.6] and HR = 1.86 IC95% [1.57; 2.19]).

Conclusion

A linear score of anemia and fatigue PSS were simple and efficient predictors of overall survival. They could be monitored to help clinicians in fatigue and anemia management.

Disclosure

S. Oudard: honoraria: Sanofi, Roche, Bayer

All other authors have declared no conflicts of interest.