Hasegawa Yuji, Fukuhara Takahiro, Fujiwara Kazunori, Takeuchi Eiji, Kitano Hiroya
Division of Otolaryngology, Head and Neck Surgery, Department of Medicine of Sensory and Motor Organs, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8504, Japan.
Yonago Acta Med. 2015 Mar;58(1):9-13. Epub 2015 Mar 27.
Head and neck squamous cell carcinoma (HNSCC) is increasing in prevalence as society ages worldwide. However, there are no established treatment protocols for elderly patients, and the threshold for defining "elderly" is undetermined. In this study, we categorized elderly patients (65 years and older) with HNSCC into 2 groups: "young-old," from 65 to 74 years old, and "old-old," 75 years and older, and compared their treatment outcomes.
The subjects were 182 patients aged 65 years and older who visited our hospital for HNSCC from 2003 to 2009. We categorized them into 2 groups, young-old (65-74 years) and old-old (75 years and older), and compared the male-female ratio, ratio with underlying diseases, primary tumor sites, disease stage, applied treatments and curative rate. Additionally, for the curative treatment category in both groups, we compared recurrence rate, relationship between recurrence rate and use of concomitant chemotherapy, the 5-year relapse-free survival and the 5-year cause-specific survival.
The ratio of patients with underlying diseases in the old-old group was significantly higher than in the young-old group, but there was no significant difference in curative rate between the 2 (old-old, 81.9%; young-old, 82.7%). The 5-year, cause-specific survival in curative treatment category was significantly lower in the old-old (66.1%) group than the young-old (94.1%) group.
Elderly patients of all ages should positively receive curative treatment. We suppose that concomitant chemotherapy is not acceptable in elderly patients. The 5-CSS of the curative treatment category in the old-old patients was significantly lower than in the young-old patients.
随着全球社会老龄化，头颈部鳞状细胞癌（HNSCC）的患病率正在上升。然而，对于老年患者尚无既定的治疗方案，且界定“老年”的阈值尚未确定。在本研究中，我们将65岁及以上的老年HNSCC患者分为两组：65至74岁的“年轻老人”组和75岁及以上的“年老老人”组，并比较了他们的治疗结果。
研究对象为2003年至2009年因HNSCC前来我院就诊的182例65岁及以上患者。我们将他们分为两组，年轻老人组（65 - 74岁）和年老老人组（75岁及以上），并比较了男女比例、合并基础疾病的比例、原发肿瘤部位、疾病分期、应用的治疗方法和治愈率。此外，对于两组的根治性治疗类别，我们比较了复发率、复发率与同步化疗使用之间的关系、5年无复发生存率和5年病因特异性生存率。
年老老人组合并基础疾病的患者比例显著高于年轻老人组，但两组的治愈率无显著差异（年老老人组为81.9%；年轻老人组为82.7%）。根治性治疗类别中，年老老人组（66.1%）的5年病因特异性生存率显著低于年轻老人组（94.1%）。
所有年龄段的老年患者都应积极接受根治性治疗。我们认为老年患者不适合接受同步化疗。年老老人患者根治性治疗类别的5年病因特异性生存率显著低于年轻老人患者。
