Long-term results of elderly nasopharyngeal carcinoma treated with conventional radiotherapy alone in 95 cases

Abstract

Objective To evaluate the outcomes and toxicities of elderly nasopharyngeal carcinoma (NPC) treated with conventional radiotherapy alone.Methods From January 1995 to December 1998,95 newly diagnosed nasopharyngeai carcinoma with age ≥65 years treated in our hospital.The clinical data were analyzed retrospectively.Kaplan-Meier method was used for analysis of local-regional control survival and distant metastasis-free survival. The Logrank test was used for univariate prognostic analysis and Cox regression was used for multivariable prognostic analysis.Results The follow-up rate was 98％.The 3-,5- and 8-year local-regional control (LRC) and distant metastasis-free survival (DMFS) rates were 89％,87％,84％ and 85％,79％,79％,respectively. The most common acute toxicities were grade1-2 leukopenia (36％),skin reaction (64％) and mucositis (66％).The most frequent late toxicities were hearing impairment (8％),trismus ( 10％ ) and radiation-induced cranial neuropathy (5％).In univariate analysis,interruption of radiotherapy ( χ2 =7.45,P =0.006 ) and regional neck lymph nodes response (χ2 =4.17,P=0.041 ) was the prognostic factors for LRC,T stage (χ2 =4.16,P=0.032),N stage ( χ2 =4.66,P =0.031 ) and interruption of radiotherapy ( χ2 =9.42,P =0.002 ) was the prognostic factors for DMFS. In multivariable analysis,interruption of radiotherapy and the regional neck lymph nodes response were the prognostic factors for LRC (χ2=6.19,P=0.013 and χ2=12.16,P=0.002;respectively),N stage and radiotherapy interruption were prognostic factors for DMFS.(χ2=15.06,P =0.000 and χ2 =21.62,P =0.000 ; respectively ).Conclusions Conventional radiotherapy alone for elder NPC can produce satisfactory results with acceptable treatment-relative toxicities.Our experience showed that the early N stage,without radiotherapy interruption and good regional lymph nodes response had a good longterm prognosis. Key words: Nasopharyngeal neoplasms, elderly/radiotherapy; Radiotherapy, conventional; Prognosis