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头颈部鳞状细胞癌姑息性放疗后的生存情况:老年患者治疗指征研究

Survival Following Palliative Radiotherapy for Head and Neck Squamous Cell Carcinoma: Examining Treatment Indications in Elderly Patients.

作者信息

Katano Atsuto, Minamitani Masanari, Tongyu Gao, Ohira Shingo, Yamashita Hideomi

机构信息

Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan.

Department of Comprehensive Radiation Oncology, The University of Tokyo, Tokyo, Japan.

出版信息

Cancer Diagn Progn. 2024 Jan 3;4(1):46-50. doi: 10.21873/cdp.10284. eCollection 2024 Jan-Feb.

Abstract

BACKGROUND/AIM: This study investigated the survival outcomes of patients with head and neck squamous cell carcinoma (HNSCC) undergoing palliative radiotherapy, particularly focusing on challenges and factors associated with older age, providing insights into appropriate palliative radiotherapy use in this demographic.

PATIENTS AND METHODS

A retrospective study was conducted using electronic medical records of 73 patients with HNSCC who were deemed unsuitable for curative therapy. Palliative radiotherapy involved a uniform dose of 30 Gy in 10 fractions. Survival analysis was performed using Kaplan-Meier method, and multivariate analysis identified significant prognostic factors.

RESULTS

The median overall survival was 7.5 months, with no significant difference between age groups. Karnofsky performance status (KPS) >70 correlated with favorable survival. Multivariate analysis confirmed KPS as an independent prognostic factor (hazard ratio=1.949, p=0.031).

CONCLUSION

The results of this study align with those of previous studies, emphasizing the importance of palliative radiotherapy for HNSCC treatment. Optimal dose fractionation regimens remain undetermined, and tailored approaches that consider factors, such as age and performance status are crucial. Individualized, comprehensive assessments and supportive care measures enhance patient well-being, reflecting palliative care principles.

摘要

背景/目的:本研究调查了接受姑息性放疗的头颈部鳞状细胞癌(HNSCC)患者的生存结局,特别关注与老年相关的挑战和因素,为该人群中适当使用姑息性放疗提供见解。

患者与方法

使用73例被认为不适合根治性治疗的HNSCC患者的电子病历进行回顾性研究。姑息性放疗采用10次分割共30 Gy的均匀剂量。采用Kaplan-Meier方法进行生存分析,并通过多变量分析确定显著的预后因素。

结果

中位总生存期为7.5个月,各年龄组之间无显著差异。卡诺夫斯基功能状态(KPS)>70与良好的生存相关。多变量分析证实KPS是一个独立的预后因素(风险比=1.949,p=0.031)。

结论

本研究结果与以往研究一致,强调了姑息性放疗对头颈部鳞状细胞癌治疗的重要性。最佳剂量分割方案仍未确定,考虑年龄和功能状态等因素的个体化方法至关重要。个体化、全面的评估和支持性护理措施可提高患者的生活质量,体现了姑息治疗原则。

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