Inherently poor survival of elderly patients with nasopharyngeal carcinoma

Head Neck. 2015 Jun;37(6):771-6. doi: 10.1002/hed.23497. Epub 2015 Feb 11.

Abstract

Background: The purpose of this study was to determine the features of the elderly patient with nasopharyngeal carcinoma (NPC).

Methods: The medical records of 212 patients with NPC, aged ≥65 years, and receiving radiotherapy were retrospectively reviewed. Comorbidity was rated using the Charlson Comorbidity Index (CCI).

Results: Twenty-four patients (11.3%) scored ≥3 and 188 patients (88.7%) scored <3 rated by CCI. The median actuarial irradiated dose of the nasopharynx was 72 Gy (range, 20-94 Gy) with 87.3% patients receiving >70 Gy. One hundred fifty-four patients had stage III/IV disease. The actuarial local control, cancer-specific survival (CSS), and overall survival (OS) rates at 5 years were 68.8%, 63.5%, and 47.0%, respectively. On multivariate analysis, stage (hazard ratio [HR], 1.489; 95% confidence interval [CI], 1.168-1.897; p = .001), the technique of radiotherapy (HR, 0.674; 95% CI, 0.476-0.953; p = .025), and anemia (HR, 3.081; 95% CI, 1.624-5.845; p = .001) were independent prognostic factors.

Conclusion: The elderly patients with NPC may inherently predict poor outcomes.

Keywords: comorbidity; elderly; nasopharyngeal carcinoma; prognosis; radiotherapy.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Brachytherapy / adverse effects
  • Brachytherapy / methods
  • Cohort Studies
  • Comorbidity*
  • Confidence Intervals
  • Disease-Free Survival
  • Dose-Response Relationship, Radiation
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Nasopharyngeal Neoplasms / mortality*
  • Nasopharyngeal Neoplasms / pathology
  • Nasopharyngeal Neoplasms / radiotherapy*
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Prognosis
  • Proportional Hazards Models
  • Radiotherapy Dosage
  • Retrospective Studies
  • Risk Assessment
  • Sex Factors
  • Survival Analysis