Department of Radiation Oncology, University of Arizona, 1501 N Campbell Ave, 85724-5081, Tucson, AZ, USA.
Strahlenther Onkol. 2012 Aug;188(8):677-83. doi: 10.1007/s00066-012-0125-0. Epub 2012 Jun 3.
In this work, the treatment tolerance of elderly patients (≥70 years) undergoing intensity-modulated radiotherapy (IMRT) and image-guided radiotherapy (IGRT) and chemotherapy for locally advanced head and neck cancer was assessed.
A retrospective review of 112 patients undergoing concurrent chemoradiation for locally advanced head and neck cancer was performed. Treatment toxicity, protocol violations, long-term complications, and survival were compared between 85 younger patients (< 70 years) and 27 older patients (≥ 70 years).
Grade 3-4 treatment toxicity was observed in 88.2% and 88.8% for younger and older patients, respectively. Mean weight loss and treatment break were 5.9 and 3.9 kg (p = 0.03) and 7.3 and 7.8 days (p = 0.8) for younger and older patients, respectively. Seven patients (8.2%) did not complete treatment in the younger group compared to 1 patient (3.7%) in the older group (p = 0.6). No significant differences in protocol violations and survival were found between the two groups.
Compared to younger patients, elderly patients with locally advanced head and neck cancer tolerated chemoradiation with IMRT and IGRT well, and should not be denied curative treatment based solely on age.
本研究评估了行调强放疗（IMRT）和图像引导放疗（IGRT）联合化疗的老年（≥70 岁）局部晚期头颈部癌患者的治疗耐受性。
对 112 例行同步放化疗的局部晚期头颈部癌患者进行回顾性分析。比较了 85 名年龄较轻（<70 岁）和 27 名年龄较大（≥70 岁）患者之间的治疗毒性、方案违反、长期并发症和生存情况。
年轻组和老年组分别有 88.2%和 88.8%的患者发生 3-4 级治疗毒性。年轻组和老年组的平均体重减轻和治疗中断分别为 5.9 和 3.9kg（p=0.03）和 7.3 和 7.8 天（p=0.8）。年轻组有 7 名（8.2%）患者未完成治疗，而老年组有 1 名（3.7%）患者未完成治疗（p=0.6）。两组在方案违反和生存方面无显著差异。
与年轻患者相比，局部晚期头颈部癌老年患者能很好地耐受 IMRT 和 IGRT 联合化疗，不应仅因年龄而拒绝给予根治性治疗。
