1053 - The usefulness of G8 evaluation in therapeutic decision and prediction of tolerance in locally advanced or metastatic squamous cell head and neck ca...

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Supportive Care
Geriatric Oncology
Head and Neck Cancers
Presenter Silvia Mihaela Ilie
Authors S.M. Ilie1, I. Ruginescu2, E. Saada2, F.R. Ferrand2, A. Schilf2, F. Janot2, J. Guigay3
  • 1Medical Oncology, Institute of Oncology Bucharest, Fundeni Clinical Hospital Alexandru Treistoreanu, 022328 - Bucharest/RO
  • 2Head And Neck Cancer Treatment, Institute Gustave Roussy, Villejuif/FR
  • 3Institute Gustave Roussy, Villejuif/FR

Abstract

Background

2/3 of H&N cancer patients are locally advanced or metastatic and 20% are older than 65. Those not amenable to radiation or surgery, must be treated evaluating their biological age. The current standard is Erbitux based chemotherapy and there are not enough dates about the tolerance for aged pts. G8 was validated like tool in geriatric oncology but the presence of swallowing difficulties and weight loss in most of HNC patients may alter its usefulness in this population.

Objective

evaluate prospectively the G8 score and to report to the incidence and degree of chemotherapy toxicities.

Methods

Prospective study of SCCHN patients over 65 years old, addressed from January to April 2012 to the Department of Head & Neck Cancer of Gustave Roussy Institute. Parameters studied: G8 score; age, TNM, histology, nutritional status, ACE -27 index, toxicity of treatment.

Results

We studied 21 patients: 9 pts (42%) less than 70, 4 pts (19%) between 70 -75 and 7 pts (33%) over 75, mostly locally advanced, squamous histological type; denutrition in 9 pts (42%) 2 over 75 years; 33% had swallowing problems and 25% loss weight superior of 10% in the last 3 months before treatment. ACE 27 index was over 2 for 18 (85%) patients.We found a G8 score < 14 for 9 (42%), of whom 8 aged over 70 years, 7 with denutrition, 5 with ACE 27 at 3. 16 patients (47%) were treated with Cetuximab based chemotherapy. The mostly observed toxicities were cutaneous with 3 grade 3 and 1 grade 4, 41%hematological and g-I from whome only 4 pts (19%) degree 3 or 4. One toxic death was observed. 12 pts were evaluated and 4 (33%) were in PR, 5 (41%) were SD and only 3 (25%) were in progression.

Conclusions

this preliminary prospective study demonstrates that G8 score identify frailty in 42% of elderly SCCHN patients older than 65 years. An adapted tool for geriatric asessement in SCCHN patients seems necessary.

Disclosure

All authors have declared no conflicts of interest.