Department of Otolaryngology, University Medical Center Groningen, University of Groningen, The Netherlands.
Oral Oncol. 2011 Dec;47(12):1159-64. doi: 10.1016/j.oraloncology.2011.08.004. Epub 2011 Aug 31.
Treatment choice in elderly pharyngeal cancer patient is disputed. This study was aimed to asses association of co-morbidity, complications and survival in different treatment modalities of pharyngeal cancer patients. Retrospective analysis of pharyngeal cancer patients, diagnosed between 1997 and 2007 in a tertiary referral hospital was performed. Patients 75years and older (n=42), were matched with two control patients 64years and younger (n=84). Co-morbidity (ACE-27), treatment related complications and survival data were assessed and analyzed. Frequency of co-morbidity was similar in both age groups, although discarding alcohol abuse resulted in higher incidence of co-morbidity in the elderly group. Complication rate was not significantly different. In a multivariate analysis only stage found to be a significant predictor of complications. Survival estimates adjusted to sex, age and birth cohort revealed co-morbidity to be a significant predictor for survival in elderly and young patients. No evidence has been found to treat elderly pharyngeal cancer patients differently than younger ones. Treatment related complications are not predicted by co-morbidities in young and elderly patients; however survival is predicted by comorbidity. Therefore thorough pre-treatment evaluation and care necessary in the elderly population.
老年咽喉癌患者的治疗选择存在争议。本研究旨在评估不同治疗方式与咽喉癌患者合并症、并发症和生存之间的关联。对 1997 年至 2007 年间在一家三级转诊医院诊断为咽喉癌的患者进行回顾性分析。将 75 岁及以上的患者（n=42）与两名年龄在 64 岁及以下的对照患者（n=84）相匹配。评估并分析合并症（ACE-27）、治疗相关并发症和生存数据。尽管排除酗酒可导致老年组合并症的发生率更高，但两组的合并症频率相似。并发症发生率无显著差异。多变量分析仅发现分期是并发症的显著预测因素。对性别、年龄和出生队列进行调整的生存估计表明，合并症是老年和年轻患者生存的显著预测因素。没有证据表明老年咽喉癌患者的治疗方式应与年轻患者不同。在年轻和老年患者中，治疗相关并发症与合并症无关；然而，合并症与生存相关。因此，在老年人群中需要进行彻底的治疗前评估和护理。
