Predictive role of vulnerable elderly study-13 screening tools in chemotherapy-related toxicity in elderly patients with lung cancer

Lung cancer patients are frail because they are usually diagnosed at an advanced age, are often accompanied by comorbidities, and are at high risk of chemotherapy toxicity. Choosing a safe and correct treatment is very important. In this study, we investigated the ability of VES-13, which measures patient frailty, to predict the side effects of chemotherapeutic drugs. This was a prospective, single-center observational study in which 131 patients aged ≥ 65 years who were scheduled to receive chemotherapy due to a lung cancer diagnosis were included. The VES-13 questionnaire was completed by all patients before treatment. Treatment-related toxicities (TRTs) while receiving chemotherapy treatment were assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Events v4.03. The median age was 70 (65-85) years. There was hematologic toxicity in 46 (35.1%) patients and nonhematologic grade 3-5 toxicity in 33 (25.2%) patients. In the univariate analysis, VES-13 (OR = 8.40, p < 0.001), platinum chemotherapy (OR = 2.53, p = 0.016) and ECOG-PS (OR = 2.60, p = 0.018) were found to be predictive of TRT. In the multivariate analysis, VES-13 remained an independent predictive feature when the predictors were evaluated together (OR = 8.26, p < 0.001). The detection of abnormal scores with the VES-13 tool revealed a greater need for initial treatment dose reduction, treatment interruption, treatment discontinuation, blood transfusion and unexpected hospital admission (p = 0.012, p < 0.001, p < 0.001, p = 0.022, and p < 0.001, respectively). We believe that the VES-13 questionnaire is a useful tool for deciding on a chemotherapy and choosing the appropriate regimen and that it should be used in outpatient clinic conditions because it is easy and short to apply.