The impact of frailty on chemotherapy intolerance in patients with cervical cancer: A longitudinal study

Abstract

Purpose

To explore the potential effects of frailty on chemotherapy intolerance in patients with cervical cancer.

Methods

A longitudinal study of patients with cervical cancer undergoing postoperative Adjuvant Chemotherapy (ACT) was conducted at a hospital in Northwest China from July 2020 to December 2021. Baseline frailty was assessed using the Tilburg Frailty Indicator. Chemotherapy intolerance was obtained from electronic medical records during the intervals between each postoperative chemotherapy session. We used Generalized Estimating Equations (GEE) to determine the predictors and cox regression analysis to analyze the impact of frailty on chemotherapy intolerance.

Results

A total of 259 patients with postoperative cervical cancer with a mean age of 52.5 years (SD = 10.3) participated in this study. The incidence of chemotherapy intolerance in the frail group at T1, T2, T3 and T4 was 51.6%, 38.9%, 55.6% and 73.7%, respectively. The patients with frailty were more likely to have chemotherapy intolerance (OR = 1.495, 95% CI: 1.074–2.080, P < 0.05), prolonged hospitalizations (OR = 1.577, 95% CI: 1.086–2.291, P < 0.05) and unplanned readmissions (OR = 2.304, 95% CI: 1.387–3.829, P < 0.05) compared to the patients without frailty. Cox regression analysis showed that frailty increased the risk of chemotherapy intolerance by 1.681-fold (HR = 1.681, 95%CI 1.041–2.713; P < 0.05) and unplanned readmissions by 2.812-fold (HR = 2.812, 95%CI 1.521–5.200; P < 0.05).

Conclusions

Frailty can lead to an increased risk of chemotherapy intolerance in patients with cervical cancer undergoing postoperative ACT, and patients with frailty are more likely to experience prolonged hospitalizations and unplanned readmissions.