108 / 154
S78
A B S T R A C T S
quality was low in 5 studies due to selection, performance and
detection bias, and only one (9%) had high quality.Therapeutic
validity was low in 5 studies (45%), mainly because of lacking
eligibility criteria for therapist or setting, or personalized
training. Interobserver agreement for methodological quality
and therapeutic validitywere good (0.80 and 0.76, respectively).
Sample sizes were relatively small (5-141 patients), only one
studie examined prehabilitation, treatment tolerance was
often not reported and methodological biases were common.
A meta-analysis was not feasible due to heterogeneity of
patients, outcomes and interventions.
Conclusion:
Home-based rehabilitation appears to im-
prove physical fitness in NSCLC patients. Although limited,
evidence seems quite consistent and feasible. Home-based
prehabilitation studies for NSCLC patients are scarce. Pros-
pective studies including larger patient samples are needed to
determine the feasibility and effectiveness of home-based (p)
rehabilitation on treatment tolerance, which ultimately could
lead to improved survival and quality of life.
Disclosure of interest:
None declared
Keywords:
Home-based, Non-small cell lung cancer, physical
fitness, prehabilitation, rehabilitation
P071
ECHOCARDIOGRAPHIC EVALUATION OF CARDIOTOXIC
DRUGS IN GERIATRIC CANCER PATIENTS: BEYOND
EJECTION FRACTION
G. Sokol
1,
*, L. Loftus
2
, J. Ayub
3
, L. Cantilena
1
1
Clinical Pharmacology, Uniformed Services University of the
Health Sciences, Bethesda,
2
Breast Program, Moffitt Cancer Center,
Tampa,
3
Florida Cancer Specialists, Hudson, USA
Introduction:
Many cancer patients are elderly and as such
often have a cardiovascular co-morbidity. Cytotoxic, targeted,
antiangiogenic agents, and monoclonal antibodies can affect
the cardiovascular system. Drug-associated cardiotoxicity
(CVTox) is commonly defined as cardiomyopathy reflected by
left ventricular ejection fraction (EF) <50% on echocardiogram
(EC). Guidelines do not include other EC abnormalities that
may have clinical import.
Objectives:
This study determined the incidence of EC
abnormalities in addition to reduced EF on echocardiograms
of cancer patients receiving chemotherapy (CHrx) and
explored potential clinical implications.
Methods:
50 patients, 36 F and 14 M, 65-97 years old,
mean age 70 years, median age 71 years, randomly selected
from a university affiliated practice from 2013-2016, who
received CHrx and underwent EC for evaluation were studied
for potential CHrx-induced CVTox. Tumor types included
25 breast, 4 lung, 7 gastrointestinal, 3 gynecologic, and 9
hematologic malignancies. 76 ECs were reviewed for EC
abnormalities including EF, valvular dysfunction, systolic or
diastolicdysfunction,pericardial disease,atrial andventricular
hypertrophy or dysfunction, and outflow hypertension. 27/50
patients received anthracyclines or trastuzumab while all
other patients received CHrx agents reported to have potential
CVTox. Observational statistics were applied.
Results:
46/50 patients had normal EFs. 9/50 patients had
no EC abnormalities. The remaining findings included 5 with
mild to severe pericardial effusions, 16 diastolic dysfunction,
15 valvular dysfunction, 12 cardiac chamber hypertrophy,
and 4 elevated outflow hypertension ranging from mild to
significant. Despite the findings of significant EC abnormalities
apart from EF, only detection of EF resulted in a change in the
CHrx regimen.
Conclusion:
CHrx, radiation therapy, targeted therapies, and
other oncologic agents can injure the cardiovascular system by
impairing heart function as well as enhancing hemodynamic
flow,thrombotic events,and conduction changes.The definition
for EC defined, drug-induced CVTox should include clinical EC
factors in addition to reduced EF that may have bearing on drug
dosing. Oncologists and pharmacists must be cognizant of the
multitude of EC adversities that may occur besides EF. Further
research will be necessary to enhance guidelines based on
factors other than EF.
Disclosure of interest:
None declared
Keywords:
Cardiotoxic drugs, echocardiogram, ejection
fraction
P072
PROSPECTIVE COHORT STUDY FROM THE EORTC (1221-ETF)
ON THE OCCURRENCE OF CANCER EVENTS IN BELGIAN
NURSING HOME RESIDENTS (NHR)
H. Wildiers
1,
*, M. Elseviers
2
, M. Mauer
3
, J. Dewolf
4
, E. Bastiaens
5
,
S. Hatse
6
, M. Hamaker
7
, F. Buntinx
8
, J. Delepeleire
9
,
G. Uytterschaut
10
, K. Tryfonidis
5
, M. Janssen-Hejinen
11
on behalf of EORTC Elderly Task Force
1
General Medical Oncology, University Hospitals Leuven, Leuven,
2
Centre for Research and Innovation in Care (CRIC), Faculty of
Medicine, Antwerp,
3
EORTC- Headquarters, Brussels,
4
Drug
Research Unit Ghent, Ghent University Hospital, Ghent,
5
EORTC
headquarters, Brussels,
6
Laboratory of Experimental Oncology (LEO),
KULeuven, Leuven, Belgium,
7
Department of Geriatric Medicine,
Diakonessenhuis, Utrecht, Netherlands,
8
Department of General
Practice, Universities of Leuven and Maastricht,
9
Departement of
General Practice KU Leuven and University Psychiatric Hospital,
KULeuven, leuven,
10
Armonea, Mechelen, Belgium,
11
Department of
Clinical Epidemiology, VieCuri Medical Centre, Venlo, Netherlands
Introduction:
Despite cancer incidence increases with age
and more elderly becoming NHR, there is very little, and only
retrospective, information available regarding diagnostic and
therapeutic approaches and cancer outcomes in NHR.
Objectives:
In order to fill this knowledge gap, and allow
better care for NHR with cancer, the EORTC elderly task force
designed a large scale prospective study on diagnostic and
therapeutic decisions for cancer events in NHR.
Methods:
The study was set up in 39 nursing homes from
the Armonea network in Belgium, covering 4262 nursing home
beds. The primary goal was to describe cancer events, referral
patterns and motives for non-referral to advanced oncological