Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2020 Apr;129(4):322-329. doi: 10.1016/j.oooo.2019.10.009. Epub 2020 Feb 24.
The purpose of this study was to investigate factors that have a significant impact on decision making regarding treatment strategies and on the resultant outcomes in older patients with oral squamous cell carcinoma (OSCC).
To define fit, vulnerable, and frail patients, as well as treatment strategies/outcomes, in patients 75 years of age and older with primary OSCC were retrospectively reviewed from the medical records.
Among patients with stage I and II tumors, those with a Geriatric 8 (G8) score of 11.5 or greater had favorable outcomes and those with a score less than 11.5 had acceptable outcomes (5-year self-reliance [SR] rates: 80.8 and 53.5%, respectively). Among patients with stage III and IV tumors, those with the Eastern Cooperative Oncology Group-Performance status (ECOG-PS) score less than 2 and/or a G8 score 11.5 or greater mainly received standard therapy, had favorable outcomes (5-year SR rate: 66.7%). The 5-year SR rates of stage IV patients with an ECOG-PS score 2 or greater and those with a G8 score less than 11.5 were poor regardless of any treatment strategy. Although the 5-year SR rate of patients with standard therapy was 73.4%, that of patients receiving other curative therapies was 0%.
In patients with stage III/IV, ECOG-PS 2 or greater, and/or G8 score less than 11.5, treatment was difficult, and the prognosis was poor.
本研究旨在探讨对老年口腔鳞状细胞癌（OSCC）患者的治疗策略决策和结果有显著影响的因素。
回顾性分析了 75 岁及以上原发性 OSCC 患者的病历，以确定适合、脆弱和虚弱患者以及治疗策略/结果。
在 I 期和 II 期肿瘤患者中，G8 评分≥11.5 的患者预后良好，评分<11.5 的患者预后可接受（5 年自理率分别为 80.8%和 53.5%）。在 III 期和 IV 期肿瘤患者中，ECOG-PS 评分<2 且/或 G8 评分≥11.5 的患者主要接受标准治疗，预后良好（5 年自理率为 66.7%）。ECOG-PS 评分≥2 且 G8 评分<11.5 的 IV 期患者无论采用何种治疗策略，5 年自理率均较差。尽管接受标准治疗的患者 5 年自理率为 73.4%，但接受其他治愈性治疗的患者 5 年自理率为 0%。
在 III/IV 期、ECOG-PS 评分≥2 和/或 G8 评分<11.5 的患者中，治疗困难，预后较差。
