Poor performance status (ECOG ≥3): patient capable of only limited self-care, confined to...

Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.

ID	`RF-FITNESS-ECOG-POOR`
Тип	Тривожна ознака
Статус	переглянуто 2026-04-27 \| очікує клінічного підпису
Хвороби	Не вказано
Джерела	`SRC-ESMO-DLBCL-2024` `SRC-NCCN-BCELL-2025`

Походження тривожної ознаки

Визначення	Poor performance status (ECOG ≥3): patient capable of only limited self-care, confined to bed/chair >50% of waking hours, or completely disabled. Generally palliative/best-supportive-care intent; cytotoxic therapy at full dose contraindicated. Selective targeted-therapy or steroid debulk may be appropriate as bridge to reassessment.
Клінічний напрям	de-escalate
Категорія	fitness-eligibility

Логіка спрацьовування

{
  "any_of": [
    {
      "comparator": ">=",
      "finding": "ecog",
      "threshold": 3
    }
  ],
  "type": "composite_score"
}

Нотатки

ECOG ≥3 routinely excludes patients from cytotoxic intensification trials. Decision is rarely "no treatment" but rather "treatment proportional to the patient's reserve": prednisolone-only debulk for steroid-responsive disease (DLBCL, ALL) to allow reassessment; rituximab-monotherapy for B-cell indolent disease; ibrutinib-monotherapy in CLL/MCL/WM; aza-monotherapy or BSC in elderly AML. Engages palliative-care consult per NCCN Palliative Care guidelines and ESMO supportive-care guidance. ECOG ≥3 caused by disease itself (e.g. DLBCL with massive disease) may improve dramatically with steroid pre-phase — reassess after 3-7 days.

Де використовується

Indications

IND-GI-NET-ADVANCED-1L-LANREOTIDE - IND-GI-NET-ADVANCED-1L-LANREOTIDE
IND-PNET-METASTATIC-1L-EVEROLIMUS - IND-PNET-METASTATIC-1L-EVEROLIMUS

Тривожна ознака

RF-FRAILTY-AGE-G8-LOW - Geriatric vulnerability flag: age ≥75 AND G8 screening score ≤14 (out of 17 max). Trigger...