The Impact of Frailty on Chemotherapy Outcomes in Patients With Digestive System Tumors: A Systematic Review and Meta-analysis.

IF 2.4 3区 医学 Q1 NURSING Cancer Nursing Pub Date : 2024-06-12 DOI:10.1097/NCC.0000000000001373
Weiyan Xu, Hailing Yang, Weihua Li, Yaqian Wang, Xu Zhang, Yuanyuan Chen
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Abstract

Background: The prevalence of patients with digestive system tumors has been high. In recent years, frailty has been considered to be associated with poor prognosis of digestive system tumors, but there are conflicting research results. A better understanding of the relationship between frailty and outcomes after chemotherapy can help advance the development of oncology care.

Objective: The aim of this study was to evaluate the effects of prechemotherapy frailty on chemotherapy toxicity, overall mortality, unplanned hospitalization, and overall survival in patients with digestive system tumors.

Methods: Up to April 2023, observational studies assessing the impact of frailty on chemotherapy outcomes in patients with digestive system tumors were collected through searching 10 online research databases. Two evaluators independently extracted literature based on the inclusion and exclusion criteria and evaluated the quality of the studies using the Newcastle-Ottawa Scale.

Results: Eventually, 11 cohort studies encompassing 2380 patients were included. The meta-analysis revealed that the frail group exhibited an increased risk of overall mortality, with poorer overall survival than the nonfrail group.

Conclusion: Frailty increases the risk of chemotherapy-induced toxic effects, unplanned hospitalization, and death in patients. However, because of this study's limited number of participants, large-sample, multicenter studies to verify these findings are required.

Implications for practice: This study provides theoretical support for incorporating frailty assessment into the nursing evaluation of patients with digestive system tumors before chemotherapy. This integration aids in predicting patients at a high risk of chemotherapy toxicity, mortality, and unplanned hospitalization, therefore providing corresponding interventions in advance to reduce adverse outcomes.

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虚弱对消化系统肿瘤患者化疗结果的影响:系统综述与元分析》。
背景:消化系统肿瘤患者的发病率一直居高不下。近年来,虚弱被认为与消化系统肿瘤的不良预后有关,但研究结果却相互矛盾。更好地了解虚弱与化疗后预后之间的关系有助于推动肿瘤护理的发展:本研究旨在评估化疗前体弱对消化系统肿瘤患者化疗毒性、总死亡率、非计划住院率和总生存率的影响:通过搜索 10 个在线研究数据库,收集了截至 2023 年 4 月评估虚弱对消化系统肿瘤患者化疗结果影响的观察性研究。两名评估者根据纳入和排除标准独立提取文献,并使用纽卡斯尔-渥太华量表对研究质量进行评估:最终,共纳入了 11 项队列研究,涉及 2380 名患者。荟萃分析表明,体弱组的总死亡率风险增加,总生存率低于非体弱组:结论:体弱会增加化疗引起的毒性反应、意外住院和患者死亡的风险。然而,由于这项研究的参与者人数有限,因此需要进行大样本、多中心研究来验证这些发现:本研究为将虚弱评估纳入消化系统肿瘤患者化疗前的护理评估提供了理论支持。这种整合有助于预测化疗毒性、死亡率和意外住院的高风险患者,从而提前提供相应的干预措施,减少不良后果。
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来源期刊
Cancer Nursing
Cancer Nursing 医学-护理
CiteScore
4.80
自引率
3.80%
发文量
244
审稿时长
6-12 weeks
期刊介绍: Each bimonthly issue of Cancer Nursing™ addresses the whole spectrum of problems arising in the care and support of cancer patients--prevention and early detection, geriatric and pediatric cancer nursing, medical and surgical oncology, ambulatory care, nutritional support, psychosocial aspects of cancer, patient responses to all treatment modalities, and specific nursing interventions. The journal offers unparalleled coverage of cancer care delivery practices worldwide, as well as groundbreaking research findings and their practical applications.
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