Horsley Patrick J, Perera Lakmalie, Veness Michael J, Stevens Mark J, Eade Thomas N, Back Michael, Brown Chris, Jayamanne Dasantha T
Radiation Oncology Department, Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
Radiation Oncology Department, Crown Princess Mary Cancer Centre, Westmead Hospital, Westmead, New South Wales, Australia.
Head Neck. 2020 Jan;42(1):25-32. doi: 10.1002/hed.25969. Epub 2019 Oct 8.
Elderly patients with mucosal squamous cell carcinomas of the head and neck (mHNSCC) represent a challenging clinical dilemma.
A retrospective review was performed of patients ≥75 years, treated with curative-intent radiotherapy for mHNSCC in two quaternary Sydney hospitals between 2007 and 2017.
Ninety-five patients met inclusion criteria. The median age was 79 years (75-94). Patients received radiotherapy alone (n = 24), concurrent chemoradiotherapy (n = 22), surgery and adjuvant radiotherapy (n = 45), or surgery with adjuvant chemoradiotherapy (n = 4). Median follow-up was 4.5 years, median overall survival (OS) was 3.8 years, and 2-year and 5-year OS were 56% and 43%, respectively. Eastern Cooperative Oncology Group performance status of ≥2 (P < .001) was a statistically significant predictor of reduced OS. Thirty-four patients (36%) required hospitalization, 5 (5%) did not complete radiotherapy, and 9 (9%) were feeding tube dependent beyond 6 months.
Appropriately selected elderly patients can achieve durable outcomes from curative intent radiotherapy with acceptable treatment toxicity.
老年头颈部黏膜鳞状细胞癌（mHNSCC）患者面临着具有挑战性的临床困境。
对2007年至2017年间在悉尼两家四级医院接受根治性放疗的≥75岁mHNSCC患者进行回顾性研究。
95例患者符合纳入标准。中位年龄为79岁（75 - 94岁）。患者接受单纯放疗（n = 24）、同步放化疗（n = 22）、手术及辅助放疗（n = 45）或手术联合辅助放化疗（n = 4）。中位随访时间为4.5年，中位总生存期（OS）为3.8年，2年和5年总生存率分别为56%和43%。东部肿瘤协作组体能状态≥2（P <.001）是总生存期缩短的统计学显著预测因素。34例患者（36%）需要住院治疗，5例（5%）未完成放疗，9例（9%）在6个月后依赖鼻饲管。
适当选择的老年患者通过根治性放疗可获得持久疗效，且治疗毒性可接受。
