Clinical characteristics and prognosis of elderly nasopharyngeal carcinoma patients receiving intensity-modulated radiot
- PDF / 2,220,725 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 85 Downloads / 183 Views
HEAD AND NECK
Clinical characteristics and prognosis of elderly nasopharyngeal carcinoma patients receiving intensity‑modulated radiotherapy Yingchen Lyu1,2 · Mengshan Ni1,2 · Ruiping Zhai1,2 · Fangfang Kong1,2 · Chengrun Du1,2 · Chaosu Hu1,2 · Hongmei Ying1,2 Received: 10 June 2020 / Accepted: 23 September 2020 © The Author(s) 2020
Abstract Purpose To evaluate the clinical characteristics and prognosis of elderly nasopharyngeal carcinoma (NPC) patients receiving intensity-modulated radiotherapy (IMRT). Methods From June 2008 to October 2014, 148 newly diagnosed non-metastatic elderly NPC patients (aged ≥ 70 years) receiving IMRT were recruited. Comorbid condition was evaluated using the age-adjusted Charlson Comorbidity Index (ACCI). Kaplan–Meier method was used to estimate survival rates and the differences were compared using log-rank test. Hazard ratio (HR) and the associated 95% confidence interval (CI) were calculated using Cox proportional hazard model by means of multivariate analysis. Results The median follow-up time was 66.35 months. Estimated OS rate at 5 years for the entire group was 61.8% (95% confidence interval [CI] 0.542–0.703). The 5-year OS rate of RT alone group was 58.4% (95% [CI] 0.490–0.696) compared with 65.2% (95% [CI] 0.534–0.796) in CRT group (p = 0.45). In patients receiving IMRT only, ACCI score equal to 3 was correlated with superior 5-year OS rate in comparison with higher ACCI score 62.1% (95% [CI] 0.510–0.766) to 48.5% (95% [CI] 0.341–0.689), respectively; p = 0.024). A 5-year OS rate of 63.1% (95% [CI] 0.537–0.741) was observed in patients younger than 75 years old compared with 57.5% (95% [CI] 0.457–0.723) in patients older (p = 0.026). Patients with early-stage disease (I–II) showed better prognosis than patients with advanced-stage (III–IV) disease (5-year OS, 72.3–55.4%, respectively; p = 0.0073). The Cox proportional hazards model suggested that age independently predicted poorer OS (HR, 1.07; 95%CI 1.00–1.15, p = 0.04). Conclusion The survival outcome of patients aged ≥ 70 years receiving IMRT only was similar to chemoradiotherapy with significantly less acute toxicities. Among the population, age is significantly prognostic for survival outcomes. Keywords Age-adjusted Charlson comorbidity index · Nasopharyngeal carcinoma · Intensity-modulated radiotherapy · Elderly
Introduction
Yingchen Lyu and Mengshan Ni contributed equally to this work. * Hongmei Ying [email protected] 1
Department of Radiation Oncology, Fudan University Shanghai Cancer Center, 270 Dong’an Road, Shanghai 200032, China
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
2
Nasopharyngeal carcinoma is characterized by its unique and extremely unbalanced geographical distribution, with 70% cases in the east and Southeast Asia [1]. Unlike the bimodal distribution in low-risk populations, the age distribution in epidemic area peaks in individuals aged 45–59 [2, 3]. As the percentage of elderly people is gradually increasing globally, the occurrence of NP
Data Loading...
