Yasuda Koichi, Kiyota Naomi, Matsuura Kazuto, Saito Satoshi, Honma Yoshitaka, Imamura Yoshinori, Tanaka Kaoru, Zenda Sadamoto, Onoe Takuma, Kodaira Takeshi, Kobayashi Satoshi, Aoyama Hidefumi, Hanai Nobuhiro, Homma Akihiro
Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan.
Department of Medical Oncology and Hematology, Cancer Center, Kobe University Hospital, Kobe, Japan.
Front Oncol. 2025 Jan 8;14:1441056. doi: 10.3389/fonc.2024.1441056. eCollection 2024.
Chemoradiation therapy (CRT) with concurrent high-dose cisplatin (CDDP) is one of the standard treatment options for locally advanced head and neck cancer. Since the indications specific to the older population have not been reported, we conducted a multicenter survey on the indications.
In April and May 2023, a questionnaire survey was emailed to all institutions belonging to the JCOG-HNCSG, consisting of 37 institutions.
The major factors influencing the indications for high-dose CDDP were renal function and performance status (PS). The majority agreed that the treatment is administered to patients aged 65-74 years with PS 0-1 and 65-74 years with eGFR ≥60 (ml/ min/1.73m2), and not in patients aged ≥75 years with PS 2, ≥80 years with PS 1, and ≥65 years with eGFR <60. Regarding weekly CDDP, the majority agreed that the treatment is not conducted in patients aged ≥75 years with PS 2, ≥65 years with eGFR <40, and ≥70 years with eGFR <50.
In Japan, where CRT is actively performed even among older people, a survey was conducted to determine its indications. Renal function and PS were considered important, and comorbidities, such as heart failure, were considered while determining the indication. These results will help define the eligibility criteria for prospective studies on CRT in older patients.
同步高剂量顺铂（CDDP）的放化疗（CRT）是局部晚期头颈癌的标准治疗选择之一。由于尚未有针对老年人群的特定适应症报道，我们开展了一项关于适应症的多中心调查。
2023年4月和5月，通过电子邮件向属于日本临床肿瘤学会头颈癌研究组（JCOG-HNCSG）的所有37家机构进行了问卷调查。
影响高剂量CDDP适应症的主要因素是肾功能和体能状态（PS）。大多数人同意，该治疗适用于65 - 74岁、PS为0 - 1且估算肾小球滤过率（eGFR）≥60（ml/min/1.73m²）的患者，而不适用于PS为2的75岁及以上患者、PS为1的80岁及以上患者以及eGFR < 60的65岁及以上患者。关于每周使用CDDP的情况，大多数人同意，该治疗不适用于PS为2的75岁及以上患者、eGFR < 40的65岁及以上患者以及eGFR < 50的70岁及以上患者。
在日本，即使在老年人中也积极开展CRT治疗，因此进行了一项调查以确定其适应症。肾功能和PS被认为很重要，在确定适应症时还考虑了心力衰竭等合并症。这些结果将有助于明确老年患者CRT前瞻性研究的入选标准。
