Piao Yongfeng, Jiang Chuner, Yan Fengqin, Ye Zhimin, Fu Zhenfu, Jiang Haitao, Jiang Yangming, Wang Yuezhen, Wang Fangzheng
Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Hangzhou 310022, People's Republic of China.
Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Zhejiang Hangzhou 310022, People's Republic of China.
J Cancer. 2020 Jul 9;11(18):5273-5280. doi: 10.7150/jca.46201. eCollection 2020.
Currently, the optimal treatment regimens for older nasopharyngeal carcinoma (NPC) patients remained unclear. The aim of this retrospective study is to investigate therapeutic patterns and survival outcomes for a cohort of older NPC patients receiving radiation therapy (RT) with or without chemotherapy (CT). The clinical data of 529 patients with aged ≥65 years and NPC, who were identified within the Surveillance, Epidemiology, and End Results (SEER) registry (years 2004-2015), were collected and retrospectively reviewed. Among these patients, 74 patients treated with RT alone and 455 cases were administrated for RT plus CT. Kaplan-Meier analysis was used to evaluate overall survival (OS) and cancer-specific survival (CSS). The differences in OS and CSS were compared using Log-rank test. The estimated OS and CSS rates at 5 years were 48.9% and 59.6%, respectively. Univariate analysis indicated that age, histology, T stage, and clinical stage were independent prognosticators of OS and CSS, while treatment option was only associated with OS. Multivariate analysis demonstrated that age, T stage, histology, and therapeutic strategy were correlated with OS, while age, T stage and histology were independent prognostic factors of CSS. Subgroup analyses showed that the combination of RT and CT yielded better OS and CSS in patients with stage T3 or N2 or III. Among these NPC patients with aged ≥65 years reported in the SEER database, treatment with RT plus CT provided longer OS than those treated with radiation therapy alone. Moreover, the combination of RT and CT obtained favorable OS and CSS in NPC patient stage T3 or N2 or III.
目前，老年鼻咽癌（NPC）患者的最佳治疗方案仍不明确。这项回顾性研究的目的是调查一组接受放疗（RT）联合或不联合化疗（CT）的老年NPC患者的治疗模式和生存结果。收集并回顾了监测、流行病学和最终结果（SEER）登记处（2004 - 2015年）中529例年龄≥65岁的NPC患者的临床数据。在这些患者中，74例仅接受放疗，455例接受放疗加化疗。采用Kaplan - Meier分析评估总生存期（OS）和癌症特异性生存期（CSS）。使用对数秩检验比较OS和CSS的差异。5年时的估计OS率和CSS率分别为48.9%和59.6%。单因素分析表明，年龄、组织学、T分期和临床分期是OS和CSS的独立预后因素，而治疗方案仅与OS相关。多因素分析表明，年龄、T分期、组织学和治疗策略与OS相关，而年龄、T分期和组织学是CSS的独立预后因素。亚组分析显示，放疗和化疗联合治疗在T3期或N2期或III期患者中产生了更好的OS和CSS。在SEER数据库中报告的这些年龄≥65岁的NPC患者中，放疗加化疗治疗的患者OS比单纯放疗患者更长。此外，放疗和化疗联合在NPC患者T3期或N2期或III期获得了良好的OS和CSS。
