Magnuson et al reported a tool for predicting severe toxicity following chemotherapy for early stage breast cancer. This can help to identify a patient who may require more aggressive management or a change in therapy. The authors are from multiple institutions from around the United States.
Patient selection: breast cancer, Stage I to III. >= 65 years of age
Parameters:
(1) breast cancer stage
(2) planned therapy with anthracycline
(3) planned treatment duration in weeks
(4) hemoglobin in g/dL and sex
(5) liver function tests
(6) number of falls in the past 6 months
(7) limits on ability to walk 1 mile
(8) someone available to give advice during a crisis
Parameter
Finding
Points
cancer stage
I
0
II or III
3
therapy with anthracycline
no
0
yes
1
treatment duration
<= 12 weeks
0
> 12 weeks
4
hemoglobin
female and > 12 g/dL
0
female and <= 12 g/dL
3
male and > 13 g/dL
0
male and <= 13 g/dL
3
liver function tests
normal
0
abnormal
3
falls in past 6 months
0
0
>= 1
4
ability to walk 1 mile
not limited at all
0
somewhat or very limited
3
someone able to give good advice
no, little or some of the time
3
most or all of the time
0
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 24
Total Score
Risk Group
Grade 3 to 5 Toxicity
0 to 5
low
19%, 27%
6 to 11
intermediate
54%, 45%
12 to 24
high
87%, 76%
Performance:
• The area under ROC curve was 0.75 in the derivation and 0.69 in the validation cohort.
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