Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, USA.
Head Neck. 2012 Aug;34(8):1147-52. doi: 10.1002/hed.21891. Epub 2011 Oct 22.
The reported decreasing benefit with increasing age from concurrent chemoradiotherapy in head and neck cancer patients prompted this retrospective review.
Two courses of cisplatin-based concurrent chemoradiotherapy were given to fit patients ≥70 years with locoregionally advanced cancers. Clinical characteristics, treatment, and outcomes were compared with those for an identically treated cohort <70 years.
There were 44 patients ≥70 and 137 patients <70 years. Clinical characteristics, treatment and toxicities were similar except that the elderly were less likely to receive both chemotherapy courses, experienced more myelosuppression, required more unplanned hospitalization, and were feeding-tube dependent longer. Projected 5-year disease-specific survival (71% vs 74%) and freedom from recurrence (69% v. 71%) were nearly identical.
Although these selected elderly patients experienced greater myelosuppression and supportive care requirements, outcomes were the same as in younger patients. Age alone should not be considered a contraindication to aggressive chemoradiotherapy for this disease.
有报道称，头颈部癌症患者接受同期放化疗的获益随年龄增长而降低，这促使我们进行了这项回顾性研究。
对年龄≥70 岁的局部晚期癌症患者给予两周期顺铂为基础的同期放化疗。比较了≥70 岁与<70 岁患者的临床特征、治疗和结局。
共有 44 例年龄≥70 岁和 137 例<70 岁的患者。除了老年人更不可能接受两个化疗周期、骨髓抑制更严重、需要更多非计划住院治疗和更长时间的管饲外，两组的临床特征、治疗和毒性相似。预计 5 年疾病特异性生存率（71%对 74%）和无复发生存率（69%对 71%）几乎相同。
尽管这些选择的老年患者经历了更严重的骨髓抑制和支持性护理需求，但他们的结局与年轻患者相同。对于这种疾病，年龄本身不应被视为强烈放化疗的禁忌症。
