Anczykowski Mahalia Zoe, Rösel Polina, Ziegler David Alexander, Fischer Laura Anna, Guhlich Manuel, El Shafie Rami A, Rieken Stefan, Dröge Leif Hendrik, Leu Martin
Department of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Göttingen, Germany.
Göttingen Comprehensive Cancer Center (G-CCC), University Medical Center Göttingen, Göttingen, Germany.
Front Oncol. 2025 May 16;15:1567655. doi: 10.3389/fonc.2025.1567655. eCollection 2025.
Primary radio(chemo)therapy is a therapeutic standard strategy for advanced anal squamous cell carcinoma (ASCC). For elderly patients evidence concerning long-term oncological outcome is scarce.
160 patients with advanced ASCC treated primarily by radio(chemo)therapy with curative intent were included. Baseline characteristics such as the Charlson Comorbidity Index as well as treatment-associated and long-term oncologic outcomes of patients with advanced (≥ 70 years) and younger (< 70 years) age were compared.
Elderly patients had more comorbidities. They less frequently received concomitant chemotherapy. Acute enteritis ≥ III° and late pelvic bone fracture occurred more frequently in elderly patients. Overall survival and progression-free survival estimates were significantly lower for elderly patients, respectively (OS: HR 2.53, 95% CI 1.54-4.18; p < 0.001 and PFS: HR 2.10, 95% CI 1.29-3.42; = 0.003). Locoregional and distant control did not show significant differences between elderly vs. younger patients.
Primary radio(chemo)therapy seems to be an effective and relatively safe treatment option also in elderly patients. The lower overall and progression-free survival estimates as well as the negative survival influence of a higher comorbidity index strengthen the necessity to comprehensively weighing up and discuss potential benefits and side effects of primary radio(chemo)therapy.
原发性放（化）疗是晚期肛管鳞状细胞癌（ASCC）的标准治疗策略。对于老年患者，关于长期肿瘤学结局的证据较少。
纳入160例主要接受放（化）疗且有治愈意图的晚期ASCC患者。比较老年（≥70岁）和年轻（<70岁）患者的基线特征，如查尔森合并症指数以及治疗相关和长期肿瘤学结局。
老年患者合并症更多。他们接受同步化疗的频率较低。老年患者中≥III°急性肠炎和晚期骨盆骨折的发生率更高。老年患者的总生存期和无进展生存期估计值分别显著更低（总生存期：风险比2.53，95%置信区间1.54 - 4.18；p < 0.001；无进展生存期：风险比2.10，95%置信区间1.29 - 3.42；p = 0.003）。老年患者与年轻患者之间的局部区域控制和远处控制无显著差异。
原发性放（化）疗似乎也是老年患者一种有效且相对安全的治疗选择。较低的总生存期和无进展生存期估计值以及较高合并症指数对生存的负面影响，强化了全面权衡和讨论原发性放（化）疗潜在益处和副作用的必要性。
