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Article: Radical radiotherapy for nasopharyngeal carcinoma in elderly patients: The importance of co-morbidity assessment

TitleRadical radiotherapy for nasopharyngeal carcinoma in elderly patients: The importance of co-morbidity assessment
Authors
Issue Date2012
PublisherPergamon. The Journal's web site is located at http://www.elsevier.com/locate/oraloncology
Citation
Oral Oncology, 2012, v. 48 n. 2, p. 162-167 How to Cite?
AbstractElderly patients represent a unique challenge for radical treatment in nasopharyngeal carcinoma (NPC) because of age and co-morbid conditions. We sought to evaluate the outcome of this particular group of patients and to identify key factors affecting treatment outcome. From 1998 to 2008, 990 consecutive NPC patients without distant metastasis were treated with radical radiotherapy with planned total dose >66 Gy. Among them, 103 (10.4%) patients were elderly aged >70 (group A). Their clinical characteristics and outcome were compared with those aged <70 (group B). Mortality at 90 days was used as a proxy of early deaths related to treatment. Co-morbidities were measured by the Adult Co-morbidity Evaluation 27 (ACE-27). Group A presented more commonly with poorer performance status. They showed higher rates of acute reaction, radiotherapy incompletion and mortality at 90 days (7.8% vs. 1.2%, p < 0.001). The 5-year overall survival rates were 43.9% and 78.1% for groups A and B, respectively (p < 0.001). No difference in failure free survival rates was noted. For group A, ACE-27 was the only predicting factor for mortality at 90 days [ACE-27 2-3 vs. 0-1: HR 15.86 (2.68-93.95), p = 0.002], and the most important prognostic factors for overall survival included age, presenting stage and ACE-27 (p < 0.05). Elderly NPC patients had poorer tolerance to radiotherapy. Early deaths related to treatment were not uncommon. A reasonable disease control can still be attained after radical radiotherapy for those who were able to survive through the peri-radiotherapy period. Patient selection and treatment approach with reference to ACE-27 should be considered. © 2011 Elsevier Ltd. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/180451
ISSN
2015 Impact Factor: 4.286
2015 SCImago Journal Rankings: 1.764
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorSze, HCKen_US
dc.contributor.authorNg, WTen_US
dc.contributor.authorChan, OSHen_US
dc.contributor.authorShum, TCYen_US
dc.contributor.authorChan, LLKen_US
dc.contributor.authorLee, AWMen_US
dc.date.accessioned2013-01-28T01:38:14Z-
dc.date.available2013-01-28T01:38:14Z-
dc.date.issued2012en_US
dc.identifier.citationOral Oncology, 2012, v. 48 n. 2, p. 162-167en_US
dc.identifier.issn1368-8375en_US
dc.identifier.urihttp://hdl.handle.net/10722/180451-
dc.description.abstractElderly patients represent a unique challenge for radical treatment in nasopharyngeal carcinoma (NPC) because of age and co-morbid conditions. We sought to evaluate the outcome of this particular group of patients and to identify key factors affecting treatment outcome. From 1998 to 2008, 990 consecutive NPC patients without distant metastasis were treated with radical radiotherapy with planned total dose >66 Gy. Among them, 103 (10.4%) patients were elderly aged >70 (group A). Their clinical characteristics and outcome were compared with those aged <70 (group B). Mortality at 90 days was used as a proxy of early deaths related to treatment. Co-morbidities were measured by the Adult Co-morbidity Evaluation 27 (ACE-27). Group A presented more commonly with poorer performance status. They showed higher rates of acute reaction, radiotherapy incompletion and mortality at 90 days (7.8% vs. 1.2%, p < 0.001). The 5-year overall survival rates were 43.9% and 78.1% for groups A and B, respectively (p < 0.001). No difference in failure free survival rates was noted. For group A, ACE-27 was the only predicting factor for mortality at 90 days [ACE-27 2-3 vs. 0-1: HR 15.86 (2.68-93.95), p = 0.002], and the most important prognostic factors for overall survival included age, presenting stage and ACE-27 (p < 0.05). Elderly NPC patients had poorer tolerance to radiotherapy. Early deaths related to treatment were not uncommon. A reasonable disease control can still be attained after radical radiotherapy for those who were able to survive through the peri-radiotherapy period. Patient selection and treatment approach with reference to ACE-27 should be considered. © 2011 Elsevier Ltd. All rights reserved.en_US
dc.languageengen_US
dc.publisherPergamon. The Journal's web site is located at http://www.elsevier.com/locate/oraloncologyen_US
dc.relation.ispartofOral Oncologyen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshComorbidityen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshNasopharyngeal Neoplasms - Radiotherapyen_US
dc.subject.meshPatient Selectionen_US
dc.subject.meshPrognosisen_US
dc.subject.meshRadiotherapy Dosageen_US
dc.subject.meshRadiotherapy, Conformal - Methodsen_US
dc.subject.meshRisk Assessment - Methodsen_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshSurvival Rateen_US
dc.subject.meshTreatment Outcomeen_US
dc.subject.meshYoung Adulten_US
dc.titleRadical radiotherapy for nasopharyngeal carcinoma in elderly patients: The importance of co-morbidity assessmenten_US
dc.typeArticleen_US
dc.identifier.emailSze, HCK: henrysze@graduate.hku.hken_US
dc.identifier.authoritySze, HCK=rp01697en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/j.oraloncology.2011.08.019en_US
dc.identifier.pmid21925925-
dc.identifier.scopuseid_2-s2.0-84856325946en_US
dc.identifier.hkuros219065-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-84856325946&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume48en_US
dc.identifier.issue2en_US
dc.identifier.spage162en_US
dc.identifier.epage167en_US
dc.identifier.isiWOS:000299954900017-
dc.publisher.placeUnited Kingdomen_US
dc.identifier.scopusauthoridSze, HCK=23490726900en_US
dc.identifier.scopusauthoridNg, WT=14825781500en_US
dc.identifier.scopusauthoridChan, OSH=37033537400en_US
dc.identifier.scopusauthoridShum, TCY=50263088600en_US
dc.identifier.scopusauthoridChan, LLK=47461072500en_US
dc.identifier.scopusauthoridLee, AWM=17035384900en_US

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