{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T05:14:42Z","timestamp":1788239682189,"version":"build-2803163510"},"reference-count":47,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T00:00:00Z","timestamp":1641513600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cancer Control"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Whether the prevalence of frailty and its clinical significance are relevant to treatment outcomes in younger (aged &lt; 65\u00a0years) cancer patients remains uncertain. This study aimed to evaluate the impact of frailty on treatment outcomes in younger cancer patients with head and neck and esophageal malignancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and methods<\/jats:title>\n                    <jats:p>This multicenter prospective study recruited 502 patients with locally advanced head and neck and esophageal cancer during 2016\u20132017 in Taiwan, aged 20\u201364\u00a0years who received curative-intent concurrent chemoradiotherapy (CCRT) as first-line antitumor treatment. Baseline frailty assessment using geriatric assessment (GA) was performed for each patient within 7 days before CCRT initiation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Frailty was observed in 169 (33.7%) of 502 middle-aged patients. Frail patients had significantly higher incidences of chemotherapy incompletion (16.6% versus 3.3%, P &lt; .001) and radiotherapy incompletion (16.6% versus 3.6%, P &lt; .001) than fit patients. During CCRT, frail patients had a significantly higher percentage of hospitalizations (42.0% versus 24.6%, P &lt; .001) and a trend toward a higher percentage of emergency room visits (37.9% versus 30.0%, P = .08) than fit patients. Frail patients more likely had a significantly higher incidence of grade \u2265 3 adverse events than fit patients during CCRT. The 1-year survival rate was 68.7% and 85.2% (hazard ratio 2.56, 95% confidence interval 1.80\u20133.63, P &lt; .001) for frail and fit patients, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study demonstrated the significance of pretreatment frailty on treatment tolerance, treatment-related toxicity, and survival outcome in younger patients with head and neck and esophageal cancer undergoing CCRT. While GA is commonly targeted toward the older population, frailty assessment by GA may also be utilized in younger patients for decision-making guidance and prognosis prediction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10732748211045276","type":"journal-article","created":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T08:25:25Z","timestamp":1641543925000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":20,"title":["Clinical Significance of Frailty on Treatment Outcome in Nongeriatric Patients With Head and Neck Cancer and Esophageal Cancer Undergoing Curative-Intent Concurrent Chemoradiotherapy"],"prefix":"10.1177","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0361-4548","authenticated-orcid":false,"given":"Wen-Chi","family":"Chou","sequence":"first","affiliation":[{"name":"Department of Hematology and Oncology, Chang Gung University, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng-Chou","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Colon and Rectal Surgery, Chang Gung Memorial Hospital Linkou Main Branch, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Yen","family":"Hung","sequence":"additional","affiliation":[{"name":"Division of Hema-Oncology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun-Wen","family":"Hsueh","sequence":"additional","affiliation":[{"name":"Department of Oncology, Keelung Chang Gung Memorial Hospital of the CGMF, Keelung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kun-Yun","family":"Yeh","sequence":"additional","affiliation":[{"name":"Department of Oncology, Keelung Chang Gung Memorial Hospital of the CGMF, Keelung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang-Hsien","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Oncology, Chang Gung Memorial Hospital at Chiayi, Chiayi, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ngan-Ming","family":"Tsang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung University, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei-Hung","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Oncology, Keelung Chang Gung Memorial Hospital of the CGMF, Keelung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya-Wen","family":"Ho","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Chang Gung University, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih-Ying","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Chang Gung University, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Ching","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Shin","family":"Hung","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology, Chang Gung University, Taoyuan, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,1,7]]},"reference":[{"key":"bibr1-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/56.3.M146"},{"key":"bibr2-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.13457"},{"key":"bibr3-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2020.01.004"},{"key":"bibr4-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24490"},{"key":"bibr5-10732748211045276","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21406"},{"issue":"6","key":"bibr6-10732748211045276","first-page":"838","volume":"17","author":"Spina M","year":"2012","journal-title":"Oncology"},{"key":"bibr7-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2018.78.8687"},{"key":"bibr8-10732748211045276","volume-title":"NCCN Clinical Practice Guidelines in Oncology. Older Adult Oncology. Version 1","author":"National Comprehensive Cancer Network","year":"2020"},{"key":"bibr9-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.54.8347"},{"key":"bibr10-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2018.04.023"},{"key":"bibr11-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2020.05.030"},{"key":"bibr12-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.01.008"},{"key":"bibr13-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1112088"},{"key":"bibr14-10732748211045276","first-page":"180","volume":"1","author":"Hsu WL","year":"2017","journal-title":"Int J Head Neck Sci"},{"key":"bibr15-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.43.6097"},{"key":"bibr16-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1994.12.2.385"},{"key":"bibr17-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1016\/j.bj.2018.04.003"},{"key":"bibr18-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199206113262403"},{"key":"bibr19-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.12.012"},{"key":"bibr20-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2011.12.022"},{"key":"bibr21-10732748211045276","first-page":"61","volume":"14","author":"Mahoney FI","year":"1965","journal-title":"Md State Med J"},{"key":"bibr22-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/9.3_Part_1.179"},{"key":"bibr23-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/56.6.M366"},{"key":"bibr24-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/53A.5.M372"},{"key":"bibr25-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1016\/j.critrevonc.2006.04.003"},{"key":"bibr26-10732748211045276","first-page":"165","volume-title":"Clinical Gerontology: A guide to assessment and intervention","author":"Sheikh JI","year":"1986"},{"key":"bibr27-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3956(75)90026-6"},{"key":"bibr28-10732748211045276","doi-asserted-by":"publisher","DOI":"10.2217\/cpr.14.72"},{"key":"bibr29-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2016.11.013"},{"key":"bibr30-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2018.03.019"},{"key":"bibr31-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2019.09.003"},{"key":"bibr32-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.101271"},{"key":"bibr33-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-017-0423-6"},{"key":"bibr34-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1007\/s12603-012-0084-2"},{"key":"bibr35-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.64.9525"},{"key":"bibr36-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2016.0855"},{"key":"bibr37-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000000860"},{"key":"bibr38-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-016-1338-x"},{"key":"bibr39-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1111\/ecc.12179"},{"key":"bibr40-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2013.3969"},{"key":"bibr41-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28316"},{"key":"bibr42-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2009.04.014"},{"key":"bibr43-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.74.9457"},{"key":"bibr44-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32779-X"},{"key":"bibr45-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1177\/1049909114566226"},{"key":"bibr46-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-020-05634-3"},{"key":"bibr47-10732748211045276","doi-asserted-by":"publisher","DOI":"10.1007\/s12603-014-0463-y"}],"container-title":["Cancer Control"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10732748211045276","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10732748211045276","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10732748211045276","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T14:22:25Z","timestamp":1777386145000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10732748211045276"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,7]]},"references-count":47,"alternative-id":["10.1177\/10732748211045276"],"URL":"https:\/\/doi.org\/10.1177\/10732748211045276","relation":{},"ISSN":["1073-2748","1526-2359"],"issn-type":[{"value":"1073-2748","type":"print"},{"value":"1526-2359","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,7]]},"article-number":"10732748211045276"}}