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A matched cohort study of standard chemo-radiotherapy versus radiotherapy alone in elderly nasopharyngeal carcinoma patients.

Zeng Q, Xiang YQ, Wu PH, Lv X, Qian CN, Guo X - PLoS ONE (2015)

Bottom Line: There was no significant difference in 5-year D-FFS between the two groups (75% vs. 73%, P=0.456).The CRT group experienced significantly more Grade ≥3 acute mucositis (46.0% vs. 28.7%, P= 0.019).When the elderly NPC patients are in good performance status following a complete evaluation of overall functional status and comorbidity conditions, standard chemo-radiotherapy is worthy of recommendation.

View Article: PubMed Central - PubMed

Affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China; Department of Medical Imaging & Interventional Radiology, Sun Yat-sen University Cancer Center, Guangzhou, China.

ABSTRACT
The impact of standard chemo-radiotherapy (CRT) as preferred therapy for elderly patients (age≥60 years) with nasopharyngeal carcinoma (NPC) remains unclear. Therefore, a strict matched cohort study was conducted to compare the survival and treatment toxicity of standard chemo-radiotherapy in the elderly NPC patients with those of radiotherapy (RT) alone. From 1998 to 2003, total 498 newly diagnosed elderly non-metastatic NPC patients were abstracted and classified into two groups by the treatments they received. For each patient in the CRT group, a matched pair in RT group was identified by matching for gender, age, histological type, T and N classifications, RT dose to primary tumor and neck nodes, and days of radiotherapy. Treatment tolerability and toxicity were clarified, and treatment outcomes were calculated and compared between the two groups. Two groups were well balanced in clinical characteristics because of the strict matching conditions. Totally 87 pairs can be assessed according to the criteria. The 5-year OS, CSS, FFS, and LR-FFS for CRT and RT groups were 62% versus 40% (P=0.013), 67% versus 47% (P=0.018), 65% versus 53% (log-rank: P=0.064, Breslow: P=0.048), and 88% versus 72%, (P=0.019), respectively. There was no significant difference in 5-year D-FFS between the two groups (75% vs. 73%, P=0.456). The CRT group experienced significantly more Grade ≥3 acute mucositis (46.0% vs. 28.7%, P= 0.019). We concluded that standard chemo-radiotherapy can achieve a reasonable local and regional control in elderly NPC patients with acceptable and reversible acute toxicity. However, distant metastasis remains the dominant failure pattern. When the elderly NPC patients are in good performance status following a complete evaluation of overall functional status and comorbidity conditions, standard chemo-radiotherapy is worthy of recommendation.

No MeSH data available.


Related in: MedlinePlus

Comparison of cancer-specific survival between the combined chemo-radiotherapy and radiotherapy alone groups.Footnote: RT, radiotherapy; CRT, standard chemo-radiotherapy.
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pone.0119593.g003: Comparison of cancer-specific survival between the combined chemo-radiotherapy and radiotherapy alone groups.Footnote: RT, radiotherapy; CRT, standard chemo-radiotherapy.

Mentions: For the 87 pairs elderly NPC patients, 81 deaths (49 in the RT group and 32 in the CRT group) were reported, of which 67 (41 in the RT group and 26 in the CRT group) were related with NPC. Other causes of death in the RT group included cerebrovascular accidents and injury. Other causes of death in the CRT group included heart failure, pneumonia and senescence. The median CSS time was 72 versus 64 months in the CRT versus RT groups, respectively. The 5-year OS rate for the whole group was 50%. A 5-year OS rate of 62% was observed in CRT group compared with 40% in RT group (P = 0.013). The 5-year CSS rate in the CRT group was 67% compared with 47% in the RT group (Fig. 3, P = 0.018).


A matched cohort study of standard chemo-radiotherapy versus radiotherapy alone in elderly nasopharyngeal carcinoma patients.

Zeng Q, Xiang YQ, Wu PH, Lv X, Qian CN, Guo X - PLoS ONE (2015)

Comparison of cancer-specific survival between the combined chemo-radiotherapy and radiotherapy alone groups.Footnote: RT, radiotherapy; CRT, standard chemo-radiotherapy.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4359128&req=5

pone.0119593.g003: Comparison of cancer-specific survival between the combined chemo-radiotherapy and radiotherapy alone groups.Footnote: RT, radiotherapy; CRT, standard chemo-radiotherapy.
Mentions: For the 87 pairs elderly NPC patients, 81 deaths (49 in the RT group and 32 in the CRT group) were reported, of which 67 (41 in the RT group and 26 in the CRT group) were related with NPC. Other causes of death in the RT group included cerebrovascular accidents and injury. Other causes of death in the CRT group included heart failure, pneumonia and senescence. The median CSS time was 72 versus 64 months in the CRT versus RT groups, respectively. The 5-year OS rate for the whole group was 50%. A 5-year OS rate of 62% was observed in CRT group compared with 40% in RT group (P = 0.013). The 5-year CSS rate in the CRT group was 67% compared with 47% in the RT group (Fig. 3, P = 0.018).

Bottom Line: There was no significant difference in 5-year D-FFS between the two groups (75% vs. 73%, P=0.456).The CRT group experienced significantly more Grade ≥3 acute mucositis (46.0% vs. 28.7%, P= 0.019).When the elderly NPC patients are in good performance status following a complete evaluation of overall functional status and comorbidity conditions, standard chemo-radiotherapy is worthy of recommendation.

View Article: PubMed Central - PubMed

Affiliation: State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China; Department of Medical Imaging & Interventional Radiology, Sun Yat-sen University Cancer Center, Guangzhou, China.

ABSTRACT
The impact of standard chemo-radiotherapy (CRT) as preferred therapy for elderly patients (age≥60 years) with nasopharyngeal carcinoma (NPC) remains unclear. Therefore, a strict matched cohort study was conducted to compare the survival and treatment toxicity of standard chemo-radiotherapy in the elderly NPC patients with those of radiotherapy (RT) alone. From 1998 to 2003, total 498 newly diagnosed elderly non-metastatic NPC patients were abstracted and classified into two groups by the treatments they received. For each patient in the CRT group, a matched pair in RT group was identified by matching for gender, age, histological type, T and N classifications, RT dose to primary tumor and neck nodes, and days of radiotherapy. Treatment tolerability and toxicity were clarified, and treatment outcomes were calculated and compared between the two groups. Two groups were well balanced in clinical characteristics because of the strict matching conditions. Totally 87 pairs can be assessed according to the criteria. The 5-year OS, CSS, FFS, and LR-FFS for CRT and RT groups were 62% versus 40% (P=0.013), 67% versus 47% (P=0.018), 65% versus 53% (log-rank: P=0.064, Breslow: P=0.048), and 88% versus 72%, (P=0.019), respectively. There was no significant difference in 5-year D-FFS between the two groups (75% vs. 73%, P=0.456). The CRT group experienced significantly more Grade ≥3 acute mucositis (46.0% vs. 28.7%, P= 0.019). We concluded that standard chemo-radiotherapy can achieve a reasonable local and regional control in elderly NPC patients with acceptable and reversible acute toxicity. However, distant metastasis remains the dominant failure pattern. When the elderly NPC patients are in good performance status following a complete evaluation of overall functional status and comorbidity conditions, standard chemo-radiotherapy is worthy of recommendation.

No MeSH data available.


Related in: MedlinePlus