Table 1 Operational definitions

Fit

Should tolerate standard adult cancer therapy in addition to the anti-emetic, growth factor, superhydration and other supportive therapies usually scheduled with standard adult cancer therapy, with no modification or abandonment of the prescribed regimen.

Vulnerable

Not likely to tolerate standard adult cancer therapy without requiring subsequent modification or abandonment of the prescribed regimen, but should tolerate an individually tailored anti-cancer treatment, plus supportive therapies. This might include treatment on an inpatient basis, and/or molecular-targeted therapy and/or reduction of cytotoxic drug in terms of dose, cycle or frequency at the oncologist’s discretion.

Frail

All functional reserves invested in basic survival, patient may not have any additional resources to cope with the stressors induced by cancer treatments. Hence supportive, palliative, molecularly-targeted and hormone modification therapies are not precluded; however high-toxicity therapies should be excluded.

Standard adult dose (SAD)

The facility where the study was conducted has well-defined chemotherapy guidelines developed by consultant oncologists with reference to the latest meta-analyses, systematic reviews, randomised controlled trials, and international and national guidelines. The SAD for each drug in each protocol is determined with reference to these resources using predefined weight-based, body surface area-based, or absolute or renal function-based dose rates. Each hospital cancer protocol is recorded in, and administered according to, the electronic chemotherapy prescribing system to ensure facility standardisation and consistent protocol delivery.

Dose alteration

Any anticancer drug in any regimen that was altered by 10% or more during the course of treatment.

Treatment completion

Is dichotomised to represent patients who:

1. Completed all cycles of treatment prescribed at baseline, or

2. Were not prescribed treatment due to patient decision or patient health, or withdrew prematurely from treatment due to toxicity, death, or patient decision.