癌症与衰老研究小组评估工具预测老年肿瘤患者治疗相关毒性效应的Meta分析  

The predictive value of the CARG tool for treatment-related toxicity in elderly cancer patients:a meta-analysis

作　　者：代水平[1] 吴锦晖[1] Dai Shuiping;Wu Jinhui(Department of Geriatrics and Gerontology,National Center for Geriatrics Clinical Medicine Research,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院,老年医学中心/干部医疗科,成都610041

出　　处：《中华老年医学杂志》2024年第4期484-489,共6页Chinese Journal of Geriatrics

基　　金：国家重点研发计划(2018YFC2002100)。

摘　　要：目的系统评价癌症与衰老研究小组(CARG)评估工具在老年肿瘤患者治疗相关毒性中的预测价值。方法计算机检索中国知网、万方、维普、PubMed、Web of Science等数据库,检索时间均从建库至2022年5月。纳入评价CARG预测老年肿瘤患者毒性反应发生风险的研究,文献质量通过诊断准确性研究质量评价工具评价,采用RevMan5.4.1和Meta-DiSc1.4软件进行Meta分析。维结果研究共纳人17篇文献,2284例老年肿瘤患者,年龄65~94岁,其中1261例患者发生3~5级毒性反应。以CARG评分小于6分为低风险时,其预测发生化疗毒性反应的合并灵敏度为0.79(0.76-0.81)、特异度为0.39(0.36-0.42),AUC为0.693(标准误为0.050);而当以小于10分为低风险时,其预测发生化疗毒性反应的合并灵敏度为0.30(0.27-0.32)、特异度为0.75(0.72-0.78),AUC为0.361(标准误为0.050)。结论CARG工具对老年肿瘤患者毒性反应发生的预测有效性中等,需更多的研究完善其评估内容。Objective To systematically review the predictive value of the Cancer Aging Research Group(CARG)tool for treatment-related toxicity in older patients with cancer.Methods The online CNKI,Wanfang,VIP,PubMed and Web of Science databases were searched,including publications from the earliest electronic records to May 2022,to identify all relevant articles assessing the predictive value of CARG in older patients with cancer.QUADAS-2 was used for literature quality evaluation,and RevMan 5.4.1 and Meta-DiSc 1.4 were used for meta-analysis.Results A total of 17 articles were included in the study,including 2284 elderly cancer patients,aged 65-94 years.Among them,1261 patients experienced grade 3-5 toxicity.With a CARG score less than 6 considered as low risk,the combined sensitivity,specificity and AUC for predicting chemotherapy toxicity were O.79(0.76-0.81),0.39(0.36-0.42)and 0.693(standard error 0.050),respectively;With a score less than 10 considered as low risk,the combined sensitivity,specificity and AUC for predicting chemotherapy toxicity were 0.30(0.27-0.32),0.75(0.72-0.78)and 0.361(standard error:0.050).Conclusions The predictive value of the CARG tool for treatment-related toxicity in elderly cancer patients is of moderate importance,and more research is needed to improve our understanding of how to appropriately use CARG for assessment.

关 键 词：毒性作用 肿瘤 评估 荟萃分析 

分 类 号：R730.5[医药卫生—肿瘤]