Wilson Traeden, Fleischer Lindsay, Patel Shivam, Bhatnagar Anil, Ahmad Nadir, Kubicek Gregory
Cooper Medical School of Rowan University, Camden, NJ, USA.
Division of Otolaryngology-Head & Neck Surgery, Cooper University Health Care, Camden, NJ, USA.
Head Neck. 2022 Nov;44(11):2370-2377. doi: 10.1002/hed.27141. Epub 2022 Jul 13.
Head and neck cancer treatment can be difficult and advancing age is associated with greater frailty. It is unclear if curative treatment for very elderly patients is beneficial. This study compared outcomes to curative treatment in patients ≥80 aged with HNSCC to patients aged 70-79.
Retrospective study of 114 patients diagnosed with HNSCC. Overall survival (OS), Disease-Free Survival (DFS), and local-regional control (LRC) were compared and adjusted for confounders.
Patients aged 70-79 had a higher median OS (35 months [95% CI, 19.58-50.42]) compared with patients aged ≥80 (19 months [11.72-26.28]; p = 0.008) but similar DFS and LRC. KPS < 90 was the stand-alone independent prognostic factor for OS (HR = 2.14 [1.05-4.38]).
Very elderly HNSCC patients (aged ≥80) can have favorable outcomes with curative therapy and advanced chronological age alone should not prohibit patients from receiving treatment. Performance status may be a greater predictor of survival outcome than age alone.
Level III.
头颈部癌的治疗可能具有挑战性，并且随着年龄的增长，身体虚弱的情况会更严重。目前尚不清楚针对高龄患者的根治性治疗是否有益。本研究比较了年龄≥80岁的头颈部鳞状细胞癌（HNSCC）患者与70 - 79岁患者接受根治性治疗的结果。
对114例诊断为HNSCC的患者进行回顾性研究。比较了总生存期（OS）、无病生存期（DFS）和局部区域控制率（LRC），并对混杂因素进行了调整。
70 - 79岁的患者中位OS较高（35个月[95%置信区间，19.58 - 50.42]），而年龄≥80岁的患者中位OS为19个月[11.72 - 26.28]；p = 0.008），但DFS和LRC相似。KPS < 90是OS的独立独立预后因素（HR = 2.14 [1.05 - 4.38]）。
高龄HNSCC患者（年龄≥80岁）接受根治性治疗可获得良好预后，仅年龄较大不应阻止患者接受治疗。功能状态可能比年龄本身更能预测生存结果。
三级。
