. 2016 Aug 31;6:199. doi: 10.3389/fonc.2016.00199

Table 5.

Predictive model for chemotherapy toxicity (83).

Items	Score
1. Age of patient	2 = 72 years or older 0 = less than 72 years
2. Cancer type	2 = gastrointestinal or genitourinary 0 = other
3. Planned chemotherapy dose	2 = standard 0 = upfront reduction
4. Planned number of chemotherapy drugs	2 = polychemotherapy 0 = monochemotherapy
5. Hemoglobin	3 = male: <11 g/dL, female: <10 g/dL 0 = male: ≥11 g/dL, female: ≥10 g/dL
6. Creatinine clearance (Jeliffe, ideal weight)	3 = less than 34 mL/min 0 = 34 mL/min or more
7. How is your hearing (with a hearing aid, if needed)?	2 = fair, poor, or totally deaf 0 = excellent or good
8. Number of falls in the past 6 months	3 = 1 or more 0 = none
9. Can you take your own medicine?	1 = with some help/unable 0 = without help
10. Does your health limit you in walking one block?	2 = somewhat limited/limited a lot 0 = not limited at all
11. During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities (like visiting with friends, relatives, etc.)?	1 = limited at least some of the time 0 = limited a little of the time or not at all
Total score	0–5 points: low risk of toxicity
	6–9 points: intermediate risk of toxicity
	10–19 points: high risk of toxicity