Vienna, Austria

ESTRO 2023

Session Item

Head and neck
Poster (Digital)
Clinical
older age: a factor of worse prognosis and tolerance in nasopharyngeal cancer
Nabila SELLAL, Morocco
PO-1188

Abstract

older age: a factor of worse prognosis and tolerance in nasopharyngeal cancer
Authors:

Mohamed Sami Amraoui1, Nabila Sellal1, Wafaa Merssetti1, Mohamed El Hfid1

1University Hospital Mohamed 6, Radiotherapy, Tangier, Morocco

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Purpose or Objective

According to the greater Casablanca cancer registry 2017, specific incidences of nasopharyngeal cancer (NPC) were higher for women between 60 and 64 years old, and men between 55 and 59 years old. Our study aimed to report clinical and therapeutic characteristics of patients who had NPC depending on their age, and to evaluate the impact of age on the treatment and prognosis of NPC

Material and Methods

it’s a retrospective study that included patients who had NPC treated by radiotherapy +/-chemotherapy between April 2017 and October 2020 in our department. Using the medical database of included patients, we gathered their medical history, received treatment, toxicities and therapeutic results. Patients were  divided into two groups: less than50 years old(group 1) and more than 50 years old(group 2). The statistical analysis was done using SPPS in its version 21

Results

153 patients were included: 91 patients in the first group and 62 patients in the second one. More comorbidities were found in older patients (22.6% vs6.6%, p=0.013). We noticed that 73.6% of young patients vs67.7% of the older ones had a locally advanced cancer (≥ Stade III). One patient had a stage I disease (group1). Induction chemotherapy was administered for 76.9% of first group's patients vs 50% of the second group (p=0.001). Regarding the concomitant treatment, 21% of older patients received carboplatine vs12% of the younger patients. During the course of radiotherapy, a break in treatment was more frequently reported in the second group (21% vs 17.6%). A definitive stop before the end of treatment was noted for one patient of the first group vs 5 patients of the second one. Hospitalization for a mean period of 4 days due to a major toxicity was required for 12.9% of older patients vs 4.3% of the younger ones. Compliance in follow-up was better in group 1(79.1% vs 59.6%, p= 0.009). Mortality was significantly higher in group 2(24.2% vs 9.9%, p=0.05) and was mostly due to a progression of the disease. Among older patients who died due to a progression of their cancer, 40% needed neoadjuvant treatment and didn’t receive it because of an expected poor tolerance after geriatric evaluation. Complete response was obtained for 72.6% of old patients and 75.8% of young patients. After a follow-up of 2 years, an OS of 44.1 months (CI95%[41.747-46.545]) was found in the first group vs an OS of 37.7 months (CI95%[33.275-42.296]) in the second one(p=0.012)(figure 1). The median of survival couldn’t be measured as we had a survival rate exceeding 50% in both groups


Conclusion

our study reflects the frequent late diagnosis in our context. Frequent comorbidities in old patients compromise the course of treatment and result in poorer tolerance, which significantly impacts the prognosis of the cancer. In our study, we found that the age of patients had a significant impact on the prognosis of NPC during a 2-year follow-up, therefore we recommend a closer surveillance of older patients during the course of treatment.