[an error occurred while processing this directive]|[an error occurred while processing this directive]
202例老年鼻咽癌放化疗疗效分析
林锦，韩露，林少俊，李睿，许昀，潘建基
350014 福州,福建省肿瘤转化医学重点实验室福建医科大学教学医院福建省肿瘤医院放疗科
Therapeutic effect of radiotherapy and chemotherapy in 202 elderly patients with nasopharyngeal carcinoma
LIN Jin, HAN Lu, LIN Shao-jun, LI Rui, XU Yun, PAN Jian-ji
Department of Radiation Oncology, Fujian Tumor Hospital, Clinical College of Fujian Medical University, Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou 350014, China
Abstract：Objective To retrospectively analyze the outcomes, adverse events, and prognostic factors in elderly patients initially diagnosed with nasopharyngeal carcinoma (NPC) who receive radiotherapy and chemotherapy. Methods From January 2004 to April 2007, 202 patients (over 60 years of age) initially diagnosed with NPC received radical radiotherapy or chemotherapy. These patients included 165 males (81.7%) and 37 females (18.3%), with a median age of 65 years (range 60—86 years). Of all patients, 1 had stage Ⅰ NPC, 25 had stage Ⅱ NPC, 120 had stage Ⅲ NPC, and 56 had stage Ⅳa/Ⅳb NPC, according to the AJCC staging system (6th edition). All patients received a radiation dose of ≥66 Gy, and 146 patients (72.3%) with locally advanced NPC also received chemotherapy. The Cox model was used for multivariate analysis. Results The follow-up rate was 100%. The 5-year local control rate, regional lymph node control rate, distant metastasis-free survival (DMFS) rate, disease-free survival rate, and overall survival (OS) rate were 93%, 94%, 82%, 74%, and 67%, respectively. The multivariate analysis revealed that T stage, N stage, and age were prognostic factors for OS and DMFS (P=0.006, 0.002, and 0.008;P=0.020, 0.002, and 0.022). The severe acute toxicities included grade 4 radiation dermatitis (1 patient, 0.5%), grade 4 radiation mucositis (2 patients, 1.0%), and grade 4 bone marrow suppression (5 patients, 2.5%). Conclusions The elderly NPC patients can tolerate radiotherapy and chemotherapy well. Multimodality therapy should be adopted for the patients aged 60—74 years who have advanced-stage NPC and good general conditions.
LIN Jin,HAN Lu,LIN Shao-jun et al. Therapeutic effect of radiotherapy and chemotherapy in 202 elderly patients with nasopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2013, 22(6): 461-464.
[1] National Comprehensive Cancer Network (NCCN). NCCN clinical practice guidelines in oncologyTM head and neck cancers V.1.2009[2013-06-10]. http://www.docin.com/p-70293681.html. [2] 高黎.鼻咽癌/殷蔚伯,余子豪,徐国镇,等.肿瘤放射治疗学(第四版).北京:中国协和医科大学出版社,2008:443-484. [3] 元姝楠,谢方云,卢泰祥,等.老年鼻咽癌患者的临床特征.癌症,2006,25:740-743. [4] Lin SJ, Pan JJ, Han L, et al. Nsopharyngeal carcinoma treated with reduced-volume intensity-modulated radiation therapy:report on the 3-year outcome of a prospective series. Int J Radiat Oncol Biol Phys,2009,76:1-8. [6] Ma X, Lu JJ, Loh KS, et al. Role of computed tomography imaging in predicting response of nasopharyngeal carcinoma to definitive radiation therapy. Laryngoscope,2006,116:2162-2165. [7] Cox JD, Stetz J, Pajak TF. Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC). Int J Radiat Oncol Biol Phys,1995,31:1341-1346. [8] 曹素梅,郭翔,李宁炜,等.1142例住院广东籍鼻咽癌患者的临床资料分析.癌症,2006,25:204-220. [9] 尹宏,曾彪,金和坤.老年鼻咽癌164例临床疗效观察.肿瘤基础与临床,2009,22:501-503. [10] Min HQ, Hong MH, Ma J, et al. A new staging system for nasopharyngeal carcinoma in China. Int J Radiat Oncol Biol Phys,1994,30:1037-1042. [11] 曾奇,郭翔,李宁炜,等.313例老年鼻咽癌患者临床及预后的回顾性研究.癌症,2008,27:289-294. [12] Ma BB, Chan AT. Recent perspectives in the role of chem.otherapy in the management of advanced nasopharyngeal carcinoma. Cancer,2005,103:22-31. [13] Mitsuhashi N, Hayakawa K, Yamakawa M, et al. Cancer in patients aged over 90 years or older:radiation therapy. Radiology,1999,211:829-833. [14] 梁荣,余忠华,林晓明,等.紫杉醇同期放化疗治疗老年局部晚期鼻咽癌45例.肿瘤学杂志,2009,(3):209-211. [15] Bernardi D, Barzan L, Franchin G, et al. Treatment of head and neck cancer in elderly patients:state of the art and guidelines. Crit Rev Oncol Hematol,2005,53:71-80. [16] Vrieling C, Collette L, Fourquent A, et al. Can patient-, treatment-and pathology-related characteristics explain the high local recurrence rate following breast-conserving therapy in young patients? Eur J Cancer,2003,39:932-944. [17] 杜莎莎,任陈,田允鸿,等.鼻咽癌根治性调强放疗后晚期耳损伤的临床研究.实用医学杂志,2011,27:3734-3736.
2013, Vol. 22 
