Combined radiotherapy and chemotherapy versus radiotherapy alone in elderly patients with nasopharyngeal carcinoma

Abstract

Currently, the impact of chemotherapy (CT) on survival outcomes in elderly patients with nasopharyngeal carcinoma (NPC) receiving radiation therapy (RT) remains controversial. This retrospective study aims to investigate survival outcomes in a cohort of elderly NPC patients receiving RT alone or together with CT.Clinical data on 529 NPC patients aged 65 years and older extracted from the Surveillance, Epidemiology, and End Results registry (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015) was collected and retrospectively reviewed. In this cohort, 74 patients were treated with RT alone and 455 individuals received RT and CT. We used propensity score matching with a 1:3 ratio to identify correlations between patients based on 6 different variables. Kaplan-Meier analysis was used to evaluate overall (OS) and cancer-specific survival (CSS). The differences in OS and CSS between the 2 treatment groups were compared using the Log-rank test and Cox proportional hazards models.The estimated 5-year OS and CSS rates for all patients were 49.5% and 59.3%, respectively. The combination of RT and CT provided longer OS than RT alone (53.7% vs 36.9%, P = .002), while no significant difference was observed in CSS (61.8% vs 51.7%, P = .074) between the 2 groups. Moreover, multivariate analysis demonstrated that the combination of CT and RT correlated favorably with OS and CSS. Subgroup analyses showed that the combination of RT and CT correlated better with both OS and CSS in patients with stage T3 or N2 or stage III.Among NPC patients aged 65 years and older, treatment with RT and CT provided longer OS than RT alone. Furthermore, the combination of RT and CT showed a better correlation with OS and CSS in NPC patients with stage T3 or N2 or stage III.

Surgical resection of the primary tumor improves survival in patients with locoregional stage T1 nasopharyngeal carcinoma: a propensity score-based matched analysis

“…Even so, the risk of age-related mortality increased with age, especially after 56 years of age. In elderly patients, oncologists should take into full consideration the combination of poor nutritional status, decreased resistance, less social support, and increased comorbidities [33]. Therefore, comprehensive risk management is necessary for elderly patients with NPC.…”

Geriatric Radiation Oncology: What We Know and What Can We Do Better?

“… 45 , 46 Moreover, age adversely affected outcomes in elderly patients receiving chemoradiation according to a SEER analysis. 47 Comorbidity has also been shown to adversely impact survival 48 , 49 and toxicity, 50 , 51 while prevalence of comorbidity in HNSCC patients increases with age. 51 , 52 Paleri et al 53 analyzed 180 patients with larynx carcinomas: 64% of patients had comorbidities, 26% more than one comorbid condition.…”

Ruthenium-based antitumor drugs and delivery systems from monotherapy to combination therapy

“…258,259 Common treatments include chemotherapy, radiation therapy, photodynamic therapy, photothermal therapy, chemodynamic therapy, immunotherapy, gene therapy, etc ., and in a combination therapy, two or more of these methods are used. Combination therapy has been widely used in clinical practice; for example, chemotherapy combined with radiotherapy is used in cancer treatment, 260 and their combination with hyperthermia has been carried out for many years. 261 New combination therapies are being developed to reduce their systemic toxicity and unsatisfactory therapeutic effect.…”