The Characteristics and Survival Outcomes in Patients Aged 70 Years and Older with Nasopharyngeal Carcinoma in the Intensity-Modulated Radiotherapy Era.
The Characteristics and Survival Outcomes in Patients Aged 70 Years and Older with Nasopharyngeal Carcinoma in the Intensity-Modulated Radiotherapy Era.
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DOI：
10.4143/crt.2017.551
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发表时间：
2019-01
影响因子：
4.6
通讯作者：
Mo HY
中科院分区：
文献类型：
--
作者：
Jin YN;Zhang WJ;Cai XY;Li MS;Lawrence WR;Wang SY;Mai DM;Du YY;Luo DH;Mo HY
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. 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. 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). 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.
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影响因子：
8.8
作者：
Zeng, L.;Tian, Y-M;Sun, X-M;Chen, C-Y;Han, F.;Xiao, W-W;Deng, X-W;Lu, T-X
通讯作者：
Lu, T-X
影响因子：
--
作者：
Zhang LF;Li YH;Xie SH;Ling W;Chen SH;Liu Q;Huang QH;Cao SM
通讯作者：
Cao SM
影响因子：
45.3
作者：
Hui, Edwin P.;Ma, Brigette B.;Chan, Anthony T.
通讯作者：
Chan, Anthony T.
影响因子：
51.1
作者：
Chen, Lei;Hu, Chao-Su;Ma, Jun
通讯作者：
Ma, Jun
原发肿瘤体积是否仍是鼻咽癌调强放射治疗的预后因素？
影响因子：
5.7
作者：
Guo, Rui;Sun, Ying;Ma, Jun
通讯作者：
Ma, Jun