Comparison of intensity-modulated radiation therapy alone vs. intensity-modulated radiation therapy combined with chemotherapy in elderly nasopharyngeal carcinoma patients (aged &gt;65 years)

Mi, Jinglin; Meng, Yiliang; Wu, Hui; Cao, Yimei; Zhang, Bin; Pan, Yufei; Zhou, Yuanyuan; Fan, Jinfang; Liao, Shu-Fang; Qin, Xiaoli; Yao, Da-Cheng; Jiang, Wei

doi:10.1007/s00066-019-01533-7

Cited by 14 publications

(14 citation statements)

References 37 publications

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“…Moreover, the aged >65 years NPC patients received insufficient cycles and doses of CT due to the poor performance status [8]. Vivek et al indicate that compared with RT alone, CCRT provided favorable survival outcomes in aged ≥ 70 years NPC patients [10], while Mi et al showed that IMRT alone, compared to IMRT plus CT, provided less grade 3 side events and comparable survival with 3-year of OS (72.1% vs. 72.5%, P=0.735), PFS (65.9% vs. 70.1%, P=0.735), DMFS (76.4% vs. 71.6%, P=0.735) and LRRFS (90.8% vs. 98.0%, P=0.735) [11]. Furthermore, the unfavorable factors including poor performance status, comorbidities, reduced organ function and decreased social support affected the tolerance of CCRT in the older patients.…”

Section: Discussionmentioning

confidence: 97%

“…In addition, an investigational study conducted by Vivek et al indicated that CCRT, compared to RT alone, provided better survival outcomes in aged ≥ 70 years NPC patients 10 . While a pair-matched study performed by Mi et al showed that compared with intensity-modulate radiotherapy (IMRT) alone, adding CT to IMRT provided comparable survival and more grade 3 toxicities 11 . Given these situations, most oncologists usually recommended RT alone for treating older NPC patients 12 , 13 .…”

Section: Introductionmentioning

confidence: 99%

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Therapeutic patterns and outcomes in older patients (aged ≥65 years) with stage II-IVB Nasopharyngeal Carcinoma: an investigational study from SEER database

Piao¹,

Jiang²,

Yan³

et al. 2020

J. Cancer

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Purpose: Currently, the optimal treatment regimens for older nasopharyngeal carcinoma (NPC) patients remained unclear. The aim of this retrospective study is to investigate therapeutic patterns and survival outcomes for a cohort of older NPC patients receiving radiation therapy (RT) with or without chemotherapy (CT). Methods: The clinical data of 529 patients with aged ≥65 years and NPC, who were identified within the Surveillance, Epidemiology, and End Results (SEER) registry (years 2004-2015), were collected and retrospectively reviewed. Among these patients, 74 patients treated with RT alone and 455 cases were administrated for RT plus CT. Kaplan-Meier analysis was used to evaluate overall survival (OS) and cancer-specific survival (CSS). The differences in OS and CSS were compared using Log-rank test. Results: The estimated OS and CSS rates at 5 years were 48.9% and 59.6%, respectively. Univariate analysis indicated that age, histology, T stage, and clinical stage were independent prognosticators of OS and CSS, while treatment option was only associated with OS. Multivariate analysis demonstrated that age, T stage, histology, and therapeutic strategy were correlated with OS, while age, T stage and histology were independent prognostic factors of CSS. Subgroup analyses showed that the combination of RT and CT yielded better OS and CSS in patients with stage T3 or N2 or III. Conclusion: Among these NPC patients with aged ≥65 years reported in the SEER database, treatment with RT plus CT provided longer OS than those treated with radiation therapy alone. Moreover, the combination of RT and CT obtained favorable OS and CSS in NPC patient stage T3 or N2 or III.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Therapeutic patterns and outcomes in older patients (aged ≥65 years) with stage II-IVB Nasopharyngeal Carcinoma: an investigational study from SEER database

Piao¹,

Jiang²,

Yan³

et al. 2020

J. Cancer

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“…[28][29][30][31] Moreover, NPC patients aged >65 years old have often received insufficient cycles and doses of CT due to their poor performance status. [10] Verma et al indicated that CCRT provided more favorable survival outcomes in NPC patients aged ≥70 years old compared with RT alone, [12] while Mi et al showed that IMRT alone provided less grade 3 side events and comparable 3-year of OS (72.1% vs 72.5%, P = .735), PFS (65.9% vs 70.1%, P = .735), distant metastasis-free survival (76.4% vs 71.6%, P = .735), and loco-regional recurrence-free survival (90.8% vs 98.0%, P = .735) compared to IMRT combined with CT. [13] Furthermore, factors including poor performance status, comorbidities, reduced organ function, and decreased social support affected the tolerance of CCRT in older patients. A higher number of grade 3 and 4 CT-related side events was correlated with cancer patients with comorbidities.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, an investigational study conducted by Verma et al indicated that CCRT, compared to RT alone, provided better survival outcomes in NPC patients aged ≥70 years [12] . In contrast, another study performed by Mi et al showed that compared with intensity-modulate radiotherapy (IMRT) alone, combining CT with IMRT provided a similar survival and higher grade 3 toxicities [13] . Given this evidence, most oncologists usually recommend RT alone for treating elderly NPC patients [14,15] .…”

Section: Introductionmentioning

confidence: 99%

“…[12] In contrast, another study performed by Mi et al showed that compared with intensitymodulate radiotherapy (IMRT) alone, combining CT with IMRT provided a similar survival and higher grade 3 toxicities. [13] Given this evidence, most oncologists usually recommend RT alone for treating elderly NPC patients. [14,15] It is unclear whether CT should be added to the treatment of elderly NPC patients.…”

Section: Introductionmentioning

confidence: 99%

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

Hua

Yan

et al. 2021

Medicine

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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.

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Long-term outcomes of chemoradiotherapy versus radiotherapy alone in patients with intermediate-risk nasopharyngeal carcinoma: a population-based analysis

Chen

Liang

et al. 2022

Eur Arch Otorhinolaryngol

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Comparison of intensity-modulated radiation therapy alone vs. intensity-modulated radiation therapy combined with chemotherapy in elderly nasopharyngeal carcinoma patients (aged >65 years)

Cited by 14 publications

References 37 publications

Therapeutic patterns and outcomes in older patients (aged ≥65 years) with stage II-IVB Nasopharyngeal Carcinoma: an investigational study from SEER database

Therapeutic patterns and outcomes in older patients (aged ≥65 years) with stage II-IVB Nasopharyngeal Carcinoma: an investigational study from SEER database

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

Long-term outcomes of chemoradiotherapy versus radiotherapy alone in patients with intermediate-risk nasopharyngeal carcinoma: a population-based analysis

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