Pre-radiotherapy frailty and associated determinants in elderly patients with thoracic tumors

Elderly patients with thoracic tumors, including lung, esophageal, or mediastinal malignancies, encounter distinct challenges when undergoing radiotherapy (RT) due to age-related frailty. Research has identified several factors that influence RT outcomes in this patient population. These factors encompass age, comorbidities, polypharmacy, types and duration of physical activity, albumin levels, psychological distress, and sleep disorders. The objective of this study was to offer a reference for the management and intervention of frailty in patients with tumors. The Chinese version of the Tilburg Frailty Index, known as the General Information Questionnaire and the Oral Frailty Screening Scale were used to assess 139 patients aged 60 years and above who were scheduled to undergo RT for thoracic tumors at Zhejiang Cancer Hospital. Multiple linear regression analysis was used to identify the factors influencing pre-RT frailty in these patients. Among the pre-RT patients with thoracic tumors included in this study, 28.1% were classified as frail, with an overall frailty score of 3.75±2.429. This encompassed social frailty (1.56±0.772), psychological frailty (0.68±0.965), physical frailty (1.51±1.525), and oral frailty (3.38±1.987). The primary factors influencing pre-RT frailty in elderly patients with thoracic tumors were age, comorbidities, multiple medications, exercise type and duration, albumin levels, psychological distress, and sleep disturbances. Elderly patients with thoracic tumors exhibit varying degrees of frailty across physical, social, psychological, and oral dimensions, with social and psychological frailty being particularly prominent. Elderly patients who were of advanced age, with multiple chronic diseases, taking multiple medications, engaging in limited resistance exercise, and having low albumin levels are especially vulnerable to frailty. Healthcare providers should prioritize the assessment of frailty in these patients and promptly implement comprehensive and feasible interventions to prevent or mitigate the onset and progression of frailty.