基础医学与临床2025，Vol.45Issue(10)：1277-1283,7.DOI:10.16352/j.issn.1001-6325.2025.10.1277
改良CARG模型指导抗癌药物剂量调整对老年肿瘤患者不良反应的影响
Impact of a modified CARG model guiding anticancer drug dose adjustments on adverse events in elderly cancer patients
摘要
Abstract
Objective To evaluate the clinical value of a modified Cancer and Aging Research Group(CARG)model in guiding anticancer drug dose adjustments for elderly cancer patients in China.Methods This prospective study enrolled patients aged≥65 years with solid tumors at the Department of Oncology,Peking Union Medical College Hospital from September 1,2022 to October 29,2023.All patients underwent comprehensive geriatric assessment(CGA)and CARG risk scoring,and were stratified into low-,intermediate-,and high-risk groups.Anti-cancer drug doses(including chemotherapy,targeted therapy or immunotherapy)were reduced proportionally based on CARG risk stratification and treatment intent(curative vs.palliative).Treatment outcomes and adverse events(AEs)were recorded regularly.Fisher's Exact Test compared AE incidence between the CARG-guided dose adjust-ment group(experimental)and the physician-experience-guided dose adjustment group(control).Receiver operating characteristic(ROC)curve analysis was used to assess the predictive value of the CARG model for severe toxicity.Results Among 166 enrolled patients(median age:71 years[range:65-90];78.3%were male;68.7%had gastro-intestinal cancers;69.3%had stageⅣ),95 were assigned to the experimental group(CARG low-risk:24[25.3%],intermediate-risk:51[53.7%],high-risk:20[21.0%])and 71 were included into the control group.By December 31,2024,81 patients experienced disease progression and 10 patients died.Overall AE rates was 92.6%in the ex-perimental group and 94.4%in the control group,while grade≥3 AEs were recorded in 45.3%vs.43.7%,respec-tively(both P＞0.05).Conclusions The modified CARG model-guided dose adjustment strategy achieved comparable safety to empirical dose adjustment,which is in line with the individualized treatment paradigm for elderly cancer pa-tients,representing a structured framework for optimizing therapeutic decision-making in geriatric oncology.关键词
老年肿瘤患者/CARG模型/化疗剂量调整/不良反应Key words
elderly cancer patients/CARG model/dose adjustments of anticancer drugs/adverse events分类
医药卫生引用本文复制引用
葛郁平,华雨薇,王利娜,侯秀凤,宋华,郭欣颖,张媛,王雅楠,管梅..改良CARG模型指导抗癌药物剂量调整对老年肿瘤患者不良反应的影响[J].基础医学与临床,2025,45(10):1277-1283,7.基金项目
中央高水平医院临床研究专项(2022-PUMCH-B-049) （2022-PUMCH-B-049）
