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首页> 外文期刊>Journal of geriatric oncology >Determination of an adequate screening tool for identification of vulnerable elderly head and neck cancer patients treated with radio(chemo)therapy
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Determination of an adequate screening tool for identification of vulnerable elderly head and neck cancer patients treated with radio(chemo)therapy

机译：确定适当的筛查工具，以鉴定接受放射（化学）疗法治疗的弱势老年头颈癌患者

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Objectives: We evaluated two proposed screening tools, the Vulnerable Elders Survey-13 (VES-13) and the G8, to identify patients who could benefit from a comprehensive geriatric assessment (CGA). Materials and Methods: All consecutive patients aged ≥ 65. years with primary head and neck cancer were assessed with VES-13, G8 and CGA. Receiver operating characteristics (ROC)-analysis was used to determine diagnostic performance of both screening instruments. Results: Fifty-one patients were recruited, of which 39.2%, 66.7% and 68.6%, were defined vulnerable when evaluated with VES-13, G8 and CGA, respectively. The area under the ROC-curves (AUC ± SE) of VES-13 (0.889 ± 0.045) and G8 (0.909 ± 0.040) did not significantly differ (P=0.7083). A sensitivity and specificity of respectively 57.1% and 100% for VES-13 (cut-off ≥ 3) and 85.7% and 75.0% for G8 (cut-off ≤ 14) was obtained. The combined score "VES-13. +. (maximum-G8)" (AUC. =0.971 ± 0.019) showed a superior AUC to G8 (P=0.0242) and VES-13 (P=0.0237). The most optimal cut-off score of 5 for the combined test resulted in a sensitivity of 91.4% and a specificity of 93.8%. Positive and negative predictive values were 100% and 51.6%, 88.2% and 70.6%, and 97.0% and 83.3% for the VES-13, G8 and combined test respectively. Conclusion: Both tools were found to have good diagnostic performance. However, at the proposed cut-off scores, our data suggest the G8 as the most optimal screening tool. Moreover, the combined tool could represent an interesting alternative.
机译：目的：我们评估了两种拟议的筛查工具，弱势老年人调查-13（VES-13）和G8，以识别可以从全面的老年医学评估（CGA）中受益的患者。材料和方法：所有连续≥65岁的原发性头颈癌患者均接受VES-13，G8和CGA评估。接受者操作特征（ROC）分析用于确定两种筛查仪器的诊断性能。结果：招募了51例患者，其中分别使用VES-13，G8和CGA进行评估时，其中39.2％，66.7％和68.6％被定义为易受攻击。 VES-13（0.889±0.045）和G8（0.909±0.040）的ROC曲线下面积（AUC±SE）没有显着差异（P = 0.7083）。对于VES-13（截止值≥3），灵敏度和特异性分别为57.1％和100％;对于G8（截止值≤14），灵敏度和特异性分别为85.7％和75.0％。综合得分“ VES-13。（最大-G8）”（AUC。= 0.971±0.019）显示出优于G8（P = 0.0242）和VES-13（P = 0.0237）的AUC。组合测试的最佳最佳截断分数为5，灵敏度为91.4％，特异性为93.8％。 VES-13，G8和组合测试的阳性和阴性预测值分别为100％和51.6％，88.2％和70.6％，以及97.0％和83.3％。结论：两种工具都具有良好的诊断性能。但是，根据建议的临界值，我们的数据表明G8是最理想的筛选工具。此外，组合工具可以代表一个有趣的替代方案。

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