Yingchen Lyu1,2, Mengshan Ni1,2, Ruiping Zhai1,2, Fangfang Kong1,2, Chengrun Du1,2, Chaosu Hu1,2, Hongmei Ying3,4. 1. Department of Radiation Oncology, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Shanghai, 200032, China. 2. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China. 3. Department of Radiation Oncology, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Shanghai, 200032, China. Hongmeiying111@163.com. 4. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China. Hongmeiying111@163.com.
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.
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 NPCpatients (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.
Authors: Wing Lok Chan; James Chung Hang Chow; Zhi-Yuan Xu; Jishi Li; Wing Tung Gobby Kwong; Wai Tong Ng; Anne W M Lee Journal: Front Oncol Date: 2022-02-01 Impact factor: 6.244