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Cancer and Aging Research Group Chemotherapy Toxicity Tool (CARG-TT)
Estimates the risk of severe (grade 3-5) chemotherapy toxicity in older adults with cancer.
Cancer and Aging Research Group Chemotherapy Toxicity Tool (CARG-TT)
Age
years
Sex
Hemoglobin
Creatinine clearance
Estimated (e.g. Jelliffe or Cockcroft-Gault formula).
mL/min
Gastrointestinal or genitourinary cancer
Planned standard-dose chemotherapy (not dose-reduced at outset)
Polychemotherapy (more than one cytotoxic drug)
Hearing fair, poor, or deaf (with or without a hearing aid)
Self-reported hearing ability.
One or more falls in the past 6 months
Needs help taking prescription medications
Limited (a little or a lot) in walking one block
Social activities limited some/most/all of the time because of physical or emotional health
Complete the fields above to see the result.
When to use
- Estimating the risk of severe chemotherapy toxicity before starting a regimen in a patient aged 65 years or older with a solid tumour.
- Complementing geriatric assessment when deciding on standard-dose versus reduced-intensity chemotherapy in older adults.
Formula
Sum of 11 weighted items: age >=72 years (2), GI/GU cancer (2), standard-dose chemotherapy (2), polychemotherapy (2), hemoglobin below sex-specific threshold - <10 g/dL in women or <11 g/dL in men (3), creatinine clearance <34 mL/min (3), hearing fair/poor/deaf (2), >=1 fall in past 6 months (3), needs help with medications (1), walking one block limited (2), decreased social activity (1). Higher scores indicate greater risk; published risk bands are 0-5 low (~30%), 6-9 intermediate (~52%), and 10 or more high (~83%) risk of grade 3-5 toxicity.
Pearls and pitfalls
- Developed and validated in patients aged 65 and older starting a new chemotherapy regimen for a solid tumour.
- Five of the 11 items come from a brief geriatric assessment (falls, medication assistance, walking, social activity, hearing) and add information beyond performance status alone.