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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.


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Distribution of patients with nasopharyngeal carcinoma according to their age (database from our department, 1992–2003).
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pone.0119593.g007: Distribution of patients with nasopharyngeal carcinoma according to their age (database from our department, 1992–2003).

Mentions: Little has been published regarding the definition therapy of elderly NPC patients. In previous elderly NPC studies, oncologists selected 60, 65 or 70 years as the cutoff point of elderly NPC [12–13,19–20]. Fig. 7 shows the distribution of patients with NPC grouped by age in our institution. We have selected 60-year-old as the cutoff point which can reflect the greatest number of elderly NPC according to epidemiology of NPC from endemic regions of China because more than 80% of the patients with NPC were aged between 30 and 59 years. Although NPC incidence remains steady or increased slightly in Southeastern China [21], the number of elderly NPC patients is increasing with the rapidly rising proportion of elderly persons, and it is therefore essential to examine optimal treatment for the elderly in the near future.


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)

Distribution of patients with nasopharyngeal carcinoma according to their age (database from our department, 1992–2003).
© Copyright Policy
Related In: Results  -  Collection

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

pone.0119593.g007: Distribution of patients with nasopharyngeal carcinoma according to their age (database from our department, 1992–2003).
Mentions: Little has been published regarding the definition therapy of elderly NPC patients. In previous elderly NPC studies, oncologists selected 60, 65 or 70 years as the cutoff point of elderly NPC [12–13,19–20]. Fig. 7 shows the distribution of patients with NPC grouped by age in our institution. We have selected 60-year-old as the cutoff point which can reflect the greatest number of elderly NPC according to epidemiology of NPC from endemic regions of China because more than 80% of the patients with NPC were aged between 30 and 59 years. Although NPC incidence remains steady or increased slightly in Southeastern China [21], the number of elderly NPC patients is increasing with the rapidly rising proportion of elderly persons, and it is therefore essential to examine optimal treatment for the elderly in the near future.

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