Analysis Of Factors Influencing Chemotherapy Toxicity In Elderly Colon Cancer Patients And The Predictive Value Of CARG Tool

Objective:The Cancer and Aging Research Group's(CARG)Toxicity Tool was designed to predict grade>3 chemotherapy-related toxicity in adults aged greater than or equal to 65 years old.To explore independent risk factors for chemotherapy toxicity in elderly colon cancer patients,and to verify the predictive effect of CARG tool on the toxicity of grade 3-5 chemotherapy in elderly colon cancer patients in China,so as to help clinicians identify high-risk patients with chemotherapy and guide treatment decisions.Methods:The clinical data of colon cancer patients aged>65 years from July 2016 to June 2018 in the Second Affiliated Hospital of Soochow University were collected.All patients were reviewed for toxicity during chemotherapy.The Chi-square test was used to analyze the patient's gender,age,KPS score and blood.To predict the predictive effect of indicators,tumor characteristics and treatment on chemotherapy toxicity in elderly colon cancer patients,binary Logisitic regression to explore independent predictors of chemotherapy toxicity.The CARG score was used to evaluate the pre-chemotherapy CARG toxicity prediction tool.The scores were divided into three risk groups:low-to-high,and the Chi-square test examined the relationship between risk grouping and toxicity.The Receiver Operating Characteristic(ROC)curve was used to analyze the predictive value of CARG tools and KPS scores for chemotherapy toxicity.Results:A total of 78 patients with colon cancer aged>65 years were enrolled in this study.The 3-5 grade chemotherapy toxicity rate was 47.4%.Univariate analysis showed that gender,hemoglobin,prealbumin,and chemotherapy regimen were associated with 3-5 grade chemotherapy toxicity.In the multivariate analysis,gender and chemotherapy drugs were independently associated with chemotherapy toxicity(P<0.05).No risk of grade 3-5 chemotherapy occurred in the low-risk group of CARG tools.In the middle-risk group,19 patients(38.8%)developed grade 3-5 toxicity,and 18 patients(78.3%)in the high-risk group developed chi-square test.<0.001,there is a difference in the incidence of toxicity in different risk groups.The area under the ROC curve for the CARG score and the KPS score were 0.695(95%CI,0.581-0.795;SE:0.060),0.535(95%CI,0.418-0.649;SE:0.0597),respectively.Conclusion:Gender and chemotherapy regimens may be two independent predictors of grade 3-5 chemotherapy toxicity in elderly colon cancer patients.CARG toxicity tools can be used to distinguish the elderly colon cancer patients with different chemotherapy risks,but the predictive value is general and needs to be further improved..The KPS score does not distinguish the risk of chemotherapy toxicity in elderly patients.