Two Scoring Systems that have the potential to predict the risk of occurrence of severe toxicity from chemotherapy in elderly cancer patients were recently developed, namely the Chemotherapy Risk Assessment Scale for High Age Patients (CRASH Score) and the Cancer and Ageing Research Group (CARG Score). The aim of the present study was to assess the feasibility of both Scoring Systems and to identify the best suitable one for its implementation in a future study at the Johanniter-Hospital in Bonn (Germany).

Both Scoring Systems classify the patients into different risk category groups. They are composed of a Toxicity Calculator. In addition to the Toxicity Calculator, the CARG Score also contains a Geriatric Assessment, which is divided into a self administered and a physician’s part. Only the patient self administered part of the Geriatric Assessment was used in this study. All questionnaires were performed in form of an interview before starting the therapy. Participants were > 70 years old and had a diagnosis of a malignancy or of a disease that requires therapy with the same agents. Only those patients with a diagnosis requiring a systemic standard therapy were included. The patients were classified into the three risk groups “Green”, “Yellow” and “Red”, according to the therapy decision of the oncologist. The required time for completion of the interviews was recorded.

10 patients were included in the study and they were on average 74.50 (± 5.36) years old and 80 % of the diagnoses were malignancies. 80 % of the participants were classified as “Green”, 10 % as “Yellow” and 10 % as “Red”. All participants completed the questions for the Toxicity Calculators and 4 completed the Geriatric Assessment. By the total CRASH Score, 10 % were classified into the risk category “middle low risk”, 80 % into “middle high risk” and 10 % into “high risk”. By the CARG Score, 30 % were classified into the risk category “low risk”, 30 % into “middle risk” and 40 % into “high risk”. The completion of the Scoring Systems took on average 28.7 (± 6.1), 4.1 (± 2.1) and 30.5 (± 23.6) minutes for the CRASH Score, the Toxicity Calculator of the CARG Score and the Geriatric Assessment of the CARG Score, respectively.

In conclusion, both Scoring Systems have the potential to help the physicians during therapy decision by predicting the risk of toxicity. The CARG Score Toxicity Calculator might be more suitable for routine due to its shorter length and better distribution of the risk categories. However, more studies correlating the estimated risk with actual toxicity are necessary.