The Characteristics and Survival Outcomes in Patients Aged 70 Years and Older with Nasopharyngeal Carcinoma in the Intensity-Modulated Radiotherapy Era
| Autor: | Dong-Mei Mai, Wangjian Zhang, Dong-Hua Luo, Mei-Su Li, Si-Yang Wang, Ya-Nan Jin, Hao-Yuan Mo, Wayne R. Lawrence, Xiu-Yu Cai, Yu-Yun Du |
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| Rok vydání: | 2019 |
| Předmět: |
Male
0301 basic medicine Cancer Research medicine.medical_specialty Intensity-modulated radiotherapy Population 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Mucositis Humans Survival outcomes Stage (cooking) education Adverse effect Aged Neoplasm Staging Proportional Hazards Models Retrospective Studies Aged 80 and over education.field_of_study Nasopharyngeal Carcinoma business.industry Proportional hazards model Nasopharyngeal Neoplasms Prognosis medicine.disease Survival Analysis Confidence interval Treatment Outcome Characteristics 030104 developmental biology Oncology Nasopharyngeal carcinoma Bone marrow suppression Chemotherapy Adjuvant 030220 oncology & carcinogenesis Female Original Article Radiotherapy Intensity-Modulated business |
| Zdroj: | Cancer Research and Treatment : Official Journal of Korean Cancer Association |
| ISSN: | 2005-9256 1598-2998 |
| DOI: | 10.4143/crt.2017.551 |
| Popis: | Purpose We aim to examine nasopharyngeal carcinoma (NPC) characteristics and survival outcomes in patients aged 70 years and older in the intensity-modulated radiotherapy (IMRT) era. Materials and Methods From 2006 to 2013, 126 non-metastatic NPC patients aged ≥ 70 years who were treated with IMRT +/‒ chemotherapy were included. Adult Comorbidity Evaluation 27 (ACE-27) was used to measure patient comorbidities. The overall survival (OS) and cancer-specific survival (CSS)were calculatedwith the Kaplan-Meier method, and differenceswere compared using the log-rank test. The Cox proportional hazards model was used to carry out multivariate analyses. Results For the entire group, only two patients (1.6%) presented stage I disease, and up to 84.1% patients had stage III-IVB disease. All patients had a comorbidity score of 0 in 24 (19.0%), 1 in 45 (35.7%), 2 in 42 (33.3%), and 3 in 15 (11.9%) patients. The main acute grade during radiotherapy was 3-4 adverse events consisting of mucositis (25.4%), bone marrow suppression (16.7%), and dermatitis (8.7%). After treatment, four patients (3.2%) developed temporal lobe injury. Five-year CSS and OS rates were 67.3% (95% confidence interval [CI], 58.6% to 77.4%) and 54.0% (95% CI, 45.6% to 63.9%), respectively. Five-year OS was significantly higher for ACE-27 score 0-1 than ACE-27 score 2-3 (72.9% and 39.9%, respectively; p < 0.001). Multivariate analyses showed ACE-27 score 0-1 was significantly associated with superior OS (hazard ratio [HR], 3.02; 95% CI, 1.64 to 5.55; p < 0.001). In addition, the rate of OS was higher for stage I-III than that of stage IV, with borderline significance (HR, 1.67; 95% CI, 0.99 to 2.82; p=0.053). But no significant advantage was observed in OS when chemotherapy was used (p > 0.05). Conclusion Our findings suggest IMRT +/– chemotherapy has a manageable toxicity and provides an acceptable survival in patients aged ≥ 70 years with NPC. ACE-27 score was significantly associated with survival outcomes in this group population. |
| Databáze: | OpenAIRE |
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