Performance Status

The PS of an individual patient predicts response and likelihood of toxicity to chemotherapy as well as overall survival. The PS scaling system used most frequently was developed by the Eastern Cooperative Oncology Group (ECOG) (see Chap. 88). Categorizing patients by their ECOG PS allows for an objective measure of capability to tolerate systemic therapies that may severely compromise the patient's health. Patients with a good PS (0-1) are more likely to tolerate intense therapy, whereas patients with a poor PS (3-4) are considered unfit for chemotherapy or surgery. There is some controversy over whether to treat patients with a PS of 2. At this point, treatment is aimed at treating comorbidities to improve the PS or the use of palliative symptomatic therapy. Patients with less advanced disease may be treated more aggressively in this scenario since the intent of treatment is curative.

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