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Risk factors for the development of early adverse events in elderly cancer patients: a prospective cohort study
Faculdade Pernambucana de Saude (FPS)
Grupo de Oncogeriatria, IMIP - R. dos Coelhos, 300 - Boa Vista, Recife - PE, 50070-550
Jurema Telles de Oliveira Lima, M.D.
Jurema Telles de Oliveira Lima
English, Portuguese, Spanish
Type of Research Project
- Clinical Project with Laboratory work
What is the background of the project?
Cancer is the second leading cause of death in Brazil and around the world. In the coming years, it will become the first because of the increasing age of the population. Aging is one of the greatest achievements of mankind and the number of elders is increasing in a markedly accelerated rate in Brazil. Today, the elderly correspond to the majority of the cancer patient population, but are less included in clinical studies and are less likely to be offered therapy, because of concerns about their ability to tolerate treatment and the increased possibility of occurrence of serious adverse events. In this context, is necessary to recognize the guiding elements of the best care offered to this population. For this, the comprehensive geriatric assessment (CGA), the clinical and laboratory characteristics and the aspects related to oncological diseases and their therapies in our reality should be better studied.
What is the aim of the project?
The objective of the study is to determine predictive factors for the occurrence of early adverse events (infection, hospitalization and death) in elderly cancer patients.
What techniques and methods are used?
A prospective cohort study involving elderly patients (≥ 60 years) with a recent cancer diagnosis, admitted since January 2015. At the time of admission, socio-demographic, clinical and laboratory variables were evaluated including a comprehensive geriatric assessment (CGA) and quality of life (QOL) by the EORTC QLQ C30 (European Organization for Research and Treatment of Cancer quality of life Questionnaire). Each patient was followed for a period of six months. Exposures considered for this study were QOL by EORTC QLQ-C30, the parameter fields of CGA and laboratory data at the start of oncological therapy. The studied outcomes were death, hospitalization and early infection (occurred in the first six months after study admission). In the follow-up, each participant was contacted by the researchers at least once a month for a period of six months, or until the occurrence of a fatal outcome. Descriptive data are given as mean (average) or median (range), for the continuous variables. Categorical variables were given as absolute and relative frequencies. Quality of life was evaluated according to the protocol proposed by EORTC QLQ C30. The Kaplan-Meier method was used to estimate the overall survival time and the respective confidence interval was of 95%. In multivariate logistic regression model for all analysis, the value of p <0.05 was considered statistically significant.
What is the role of the student?
- The student will mainly observe
What are the tasks expected to be accomplished by the student?
The students are expected to observe and eventually take part of the evaluation of socio-demographic, clinical and laboratorial variables of the study. They will be supervised by other medical students, doctors and members of the multiprofessional team while performing the clinical geriatric avaliation or laboratorial tests, which are: the screening of innate and adaptive response - natural Killers, inflammatory cytokines, lymphocytes B and T and subpopulations, T regulations cells, tool like-receptor in monocytes and neutrophilis. It is also expected that students engage on the analysis of the partial results of the research.
Will there be any theoretical teaching provided (preliminary readings, lectures, courses, seminars etc)
Yes. Articles will be sent to the students via e-mail.
What is expected from the student at the end of the research exchange? What will be the general outcome of the student?
- The student will prepare a poster - The student will prepare a presentation
What skills are required of the student? Is there any special knowledge or a certain level of studies needed?
The hability to empathize is the most important one for this project.
Are there any legal limitations in the student’s involvement
Type of students accepted
This project accepts: - Medical students
- Practice guideline: Comprehensive Geriatric Assessment (CGA) in oncological patients. http://siog.org/files/public/cga_practice_guideline_wildiers_jul2011.pdf
- Designing therapeutic clinical trials for older and frail adults with cancer: U13 conference recommendations. Journal of Clinical Oncology; New York; v. 32; n. 24; 2587-94; 2014.
- Improving the evidence base for treating older adults with cancer: American Society of Clinical Oncology statement. Journal of Clinical Oncology; New York; v. 33; n. 32; p. 3826-33; 2015.
- Predicting chemotherapy toxicity in older adults with cancer: a prospective multicenter study. Journal of Clinical Oncology; New York; v. 29; n. 25; p. 3457-65; 2011.
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