Assessment of chemotherapy dosing and regimen optimization in geriatric oncology patients diagnosed with solid organ malignancies

IntroductionThe rising geriatric population has led to an increase in cancer diagnoses, with treatment decisions complicated by variable functional status and co-morbidities. This study compared chemotherapy dosing strategies, evaluated efficacy and safety, explored correlations with CRASH, CARG, G8, and CGA tools, and examined cancer incidence in older patients.MethodsA hospital-based retro-prospective study was conducted at tertiary care cancer hospital over six months, with prior ethical approval. Patients aged ≥65 years with solid organ malignancies receiving chemotherapy were assessed using the Cancer and Aging Research Group (CARG), Chemotherapy Risk Assessment Scale for High Age Patients (CRASH), and Geriatric-8 (G8) tools. Those failing G8 underwent Comprehensive Geriatric Assessment (CGA). Statistical analysis was performed using the Kruskal-Wallis test.ResultsA total of 154 patients were enrolled (88 males, 57.1%; 66 females, 42.9%). Of these, 71 (46.1%) received standard doses, while 83 (53.9%) received reduced doses during the first cycle. Among 109 patients failing G8, CGA was conducted. Adverse effects-including weakness, nausea, and ulcers occurred in 78 patients (71.6%). Depression correlated significantly with CARG (p=0.02). CRASH and CARG showed no direct correlation (p=0.433); however, ADRs were significantly associated with CRASH (p=0.01), while dosage adjustments correlated with CARG (p=0.04).ConclusionCancer care in geriatric patients requires individualised dosing guided by structured screening and geriatric assessment tools. Integrating CARG, CRASH, G8, and CGA into treatment planning enhances safety and efficacy by balancing therapeutic benefits with toxicity risks.