Chemoradiotherapy as Definitive Treatment for Elderly Patients with Head and Neck Cancer
Chemoradiotherapy as Definitive Treatment for Elderly Patients with Head and Neck Cancer
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DOI：
10.1155/2018/3508795
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发表时间：
2018-01-01
影响因子：
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通讯作者：
Balermpas, Panagiotis
中科院分区：
文献类型：
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作者：
von der Gruen, Jens Mueller;Martin, Daniel;Balermpas, Panagiotis
背景。随着人口老龄化和头颈鳞状细胞癌（SCCHN）发病率的上升，迫切需要制定治疗老年患者的策略。患者和方法。我们回顾性分析了 158 名接受明确同步放化疗 (CRT) 治疗的 SCCHN 患者。比较了 65 岁、70 岁和 75 岁以下和年长（或等于）患者的临床病理学特征、急性毒性和肿瘤学结果。结果。各组之间的放疗剂量、化疗方案和总化疗剂量是平衡的。中位随访 29 个月后，按年龄 >= 65 岁、>= 70 岁或 >= 75 岁分层的总生存期 (OS)、无进展生存期 (PFS)、局部控制率和无远处转移生存期没有显示差异。老年患者的急性毒性发生率也不高。较差的 ECOG 表现评分 (ECOG 2-3) 与 OS (p = 0.004) 和 PFS (p = 0.048) 受损相关。结论。 CRT根治性治疗SCCHN可行、有效；即使在高龄，也应根据一般状况和合并症做出治疗决定，而不仅仅是日历年龄。
Background. With the aging population and a rising incidence of squamous cell carcinoma of the head and neck (SCCHN), there is an emerging need for developing strategies to treat elderly patients. Patients and Methods. We retrospectively analyzed 158 patients treated with definitive, concurrent chemoradiotherapy (CRT) for SCCHN. Clinicopathological characteristics, acute toxicities, and oncological outcomes were compared between patients younger and older than (or of age equal to) 65, 70, and 75 years. Results. RT dose, chemotherapy regimen, and total chemotherapy dose were balanced between the groups. After a median follow-up of 29 months, overall survival (OS), progression-free survival (PFS), local control rate, and distant metastasis-free survival stratified by age of >= 65, >= 70, or >= 75 years revealed no differences. The rate of acute toxicities was also not higher for older patients. Worse ECOG performance score (ECOG 2-3) was associated with impaired OS (p = 0.004) and PFS (p = 0.048). Conclusion. Definitive treatment with CRT for SCCHN is feasible and effective; even in advanced age treatment decisions should be made according to general condition and comorbidity, rather than calendar age alone.