J Cancer 2020; 11(18):5273-5280. doi:10.7150/jca.46201 This issue

Research Paper

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

Yongfeng Piao1,2,3,4*, Chuner Jiang1,5,6*, Fengqin Yan1,2,3,4, Zhimin Ye1,2,3,4, Zhenfu Fu1,2,3,4, Haitao Jiang1,7,8, Yangming Jiang9, Yuezhen Wang1,2,3,4✉, Fangzheng Wang1,2,3,4✉

1. Department of Radiation Oncology, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Hangzhou 310022, People's Republic of China.
2. Institute of Cancer and Basic Medicine (ICBM), Chinese Academy of Sciences, Zhejiang Hangzhou 310022, People's Republic of China.
3. Department of Radiation Oncology, Zhejiang Cancer Hospital, Zhejiang Hangzhou, 310022, People's Republic of China.
4. Key Laboratory of Radiation Oncology of Zhejiang Province, Zhejiang Hangzhou, 310022, People's Republic of China.
5. Department of Breast Tumor Surgery, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Hangzhou 310022, People's Republic of China.
6. Department of Breast Tumor Surgery, Zhejiang Cancer Hospital, Zhejiang Hangzhou, 310022, People's Republic of China.
7. Department of Radiology, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Hangzhou 310022, People's Republic of China.
8. Department of Radiology, Zhejiang Cancer Hospital, Zhejiang Hangzhou, 310022, People's Republic of China.
9. Department of Didital Earth, Institute of Remote Sensing and Didital Earth, CAS, Beijing, 100101, People's Republic of China.
*These authors have contributed equally to this work.

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Citation:
Piao Y, Jiang C, Yan F, Ye Z, Fu Z, Jiang H, Jiang Y, Wang Y, Wang F. Therapeutic patterns and outcomes in older patients (aged ≥65 years) with stage II-IVB Nasopharyngeal Carcinoma: an investigational study from SEER database. J Cancer 2020; 11(18):5273-5280. doi:10.7150/jca.46201. Available from https://www.jcancer.org/v11p5273.htm

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Abstract

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.

Keywords: nasopharyngeal carcinoma, older, therapeutic pattern, survival, prognosis