Radiotherapy for locally advanced head and neck cancer in elderly patients: results and prognostic factors a single cohort
| Autor: | Leonardo Vicente Fay Neves, Gustavo Arruda Viani, Alexandre Ciufi Faustino, Marco Henrique Fernandes, Fernando Kojo Matsuura, Anielle Freitas Bendo Danelichen, Juliana Pavoni Fernandes |
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| Rok vydání: | 2021 |
| Předmět: |
Oncology
IDOSOS medicine.medical_specialty Chemotherapy Univariate analysis Multivariate analysis business.industry medicine.medical_treatment Head and neck cancer Retrospective cohort study medicine.disease outcomes elderly Radiation therapy Internal medicine Cohort medicine Radiology Nuclear Medicine and imaging head and neck cancer Stage (cooking) business radiotherapy Research Paper |
| Zdroj: | Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual) Universidade de São Paulo (USP) instacron:USP Reports of Practical Oncology and Radiotherapy |
| Popis: | Background: The objective of this study was to assess the treatment outcomes and prognostic factors of elderly patients with locally advanced head and neck cancer (LAHNC) undergoing radiotherapy (RT). Materials and methods: A retrospective cohort from a single institution, from 2000 to 2015, including patients older than 65 years old with LAHNC (stage III–IVa) treated by RT combined or not with chemotherapy (CRT). Univariate and multivariate analysis (MVA) were performed to identify prognostic factors associated with overall survival (OS), cancer-specific survival (CSS), and locoregional control (LRC). A p-value < 0.05 was considered significant. Results: 220 patients with LAHNC and > 65 years of age were identified. The median follow-up was 3.8 years, the 3/5 years estimated OS, CSS, and LRC rate was 40%/30%, 49%/34%, 76%/45%, respectively. In the univariate analysis, clinical stage (III vs. IVa/b, p = 0.01), tumor stage (T1/2 vs . T3/4, p = 0.035), Karnofsky performance status (KPS, 60–70, p = 0.03) and tumor site (other than vs. hypopharynx, p = 0.0001) were associated with lower OS. Patients with clinical stage (III vs. IVa/b, p = 0.01), tumor stage (T1/2 vs. T3/4, p = 0.015), N stage (N0/1 vs. N2/3, p = 0.04), (KPS 60-70, p = 0.04) and tumor site (other than vs. hypopharynx, p = 0.0001) had worst CSS. For the LRC, clinical stage (III vs. IVa/b, p = 0.02), tumor stage (T1/2 vs. T3/4, p = 0.02), treatment type (CRT vs. RT, p = 0.02), RT technique (IMRT vs. 2DRT/3DRT, p = 0.0001), and tumor site (other than vs. hypopharynx, p = 0.02) were significant. In the MVA, KPS maintained significant for OS and CSS. For LRC, clinical stage (Iva/b, p = 0.007), tumor stage (T3/4, p = 0.047) and radiotherapy technique other than IMRT (p = 0.0001) were significant. Conclusion: The OS, CSS, and LRC were associated with several prognostic factors. The clinical performance was the main marker of OS and CSS. Chemoradiation should be offered to selected elderly patients using IMRT to improve LRC. |
| Databáze: | OpenAIRE |
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