Performance status in clinical oncology: different import in protocol and non-protocol settings (Meeting abstract).

Important note: Information in this article was accurate in 1997. The state of the art may have changed since the publication date.

Performance status in clinical oncology: different import in protocol and non-protocol settings (Meeting abstract).

Proc Annu Meet Am Soc Clin Oncol; 15:A1617 1996. Unique Identifier : AIDSLINE ICDB/97636617
Hausner P; Otterson G; Mcelroy K; Curt GA; Medicine Branch, NCI, Bethesda, MD 20892

Abstract: A 35-year-old male patient with AIDS and pulmonary Kaposi's sarcoma who was started on paclitaxel chemotherapy while in need of respiratory assistance for respiratory failure, and then 2 lived 11+ months, is presented as a case against dogmatic use of performance status (PS) to govern the utilization of non-protocol chemotherapy. PS measured on the Karnovsky scale or according to ECOG (Zubrod) was found in most studies to be an independent factor predicting survival. This is not surprising given the fact that PS is a prognostic factor in noncancer patient populations as well as in healthy subjects. To spare very sick patients toxic therapy, and to decrease variability in study results, most therapeutic clinical trials consider patients with PS above 2 ineligible. As oncologic therapy is widely based on evidence from clinical trials, a PS below 2 is often used to select patients for non-protocol chemotherapy. This approach is convenient because probabilities of therapeutic outcomes,as well as complications derived from published studies,can be directly presented to patients as best estimates of their course of therapy. This convenience should not justify denying treatment to patients with a PS above 2, if their high PS is caused by cancer-induced organ damage, paraneoplastic symptoms or other conditions judged to be reversible by cancer or other therapy. Clinical trial data obtained on groups of patients have to be applied cautiously to individual patients.

Keywords: Acquired Immunodeficiency Syndrome/*COMPLICATIONS/PHYSIOPATHOLOGY Adult Antineoplastic Agents, Phytogenic/*THERAPEUTIC USE Clinical Protocols Human *Karnofsky Performance Status Lung Neoplasms/COMPLICATIONS/*DRUG THERAPY/PHYSIOPATHOLOGY Male Paclitaxel/*THERAPEUTIC USE Sarcoma, Kaposi's/COMPLICATIONS/*DRUG THERAPY/PHYSIOPATHOLOGY Treatment Outcome ABSTRACT
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M9731526

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