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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 failure-free survival between the combined chemo-radiotherapy and radiotherapy groups.Footnote: RT, radiotherapy; CRT, standard chemo-radiotherapy.
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pone.0119593.g004: Comparison of failure-free survival between the combined chemo-radiotherapy and radiotherapy groups.Footnote: RT, radiotherapy; CRT, standard chemo-radiotherapy.

Mentions: The 5-year FFS were 65% versus 53% for the CRT versus RT groups, respectively (Fig. 4), this difference was marginal statistical significant (log-rank: P = 0.064, Breslow: P = 0.048). The 5-year LR-FFS for the CRT group were greater than that for the RT group (88% vs. 72%, P = 0.019; Fig. 5). Therefore, patients who receive CRT had a reduced risk of local-regional relapse, with a hazard ratio of 0.403 (95% CI, 0.183–0.886; P = 0.024).


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 failure-free survival between the combined chemo-radiotherapy and radiotherapy 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.g004: Comparison of failure-free survival between the combined chemo-radiotherapy and radiotherapy groups.Footnote: RT, radiotherapy; CRT, standard chemo-radiotherapy.
Mentions: The 5-year FFS were 65% versus 53% for the CRT versus RT groups, respectively (Fig. 4), this difference was marginal statistical significant (log-rank: P = 0.064, Breslow: P = 0.048). The 5-year LR-FFS for the CRT group were greater than that for the RT group (88% vs. 72%, P = 0.019; Fig. 5). Therefore, patients who receive CRT had a reduced risk of local-regional relapse, with a hazard ratio of 0.403 (95% CI, 0.183–0.886; P = 0.024).

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