Impaired geriatric 8 score is associated with worse survival after radical intensity modulated radiation therapy in elderly patients with nasopharyngeal carcinoma

Acta Otolaryngol. 2023 Apr;143(4):334-339. doi: 10.1080/00016489.2023.2190769. Epub 2023 Mar 30.

Abstract

Background: Geriatric 8 score (G8) was an independent prognostic factor for survival and toxicities in various malignancies, but it has never been tested in nasopharyngeal carcinoma (NPC).

Objectives: To evaluate the value of G8 in predicting survival in elderly patients with NPC.

Material and methods: Patients with NPC aged ≥70 who received intensity-modulated radiation therapy were recruited into this study. The overall survival (OS), progression-free survival (PFS), locoregional recurrence rate (LRR), and distant metastasis rate (DMR) between the patients with G8 > 14 and G8 ≤ 14 were calculated using the Kaplan-Meier method and compared with the Log-rank test. Cox proportional hazards model was applied to perform univariate and multivariate analysis.

Results: G8 ≤ 14 had significantly reduced OS (p = .001) and PFS (p = .032) than those with G8 > 14 by log-rank test. G8 score remained an independent prognosticator for OS (HR = 0.490, 95% CI = 0.267-0.900, p = .021) and was a borderline significance towards PFS (HR = 0.639, 95% CI = 0.386-1.058, p = .082) in multivariate analysis. Grade 3-4 acute toxicities were significantly more common in patients with G8 ≤ 14 than in those with G8 > 14.

Conclusions and significance: G8 is useful in predicting the OS in elderly patients with NPC. Further prospective study stratified by G8 is needed to explore the value of CT in elderly patients with NPC.

Keywords: Nasopharyngal carcinoma; chemotherapy; elderly patients; geriatric 8; intensity-modulated radiation therapy.

MeSH terms

  • Aged
  • Carcinoma*
  • Disease-Free Survival
  • Humans
  • Nasopharyngeal Carcinoma
  • Nasopharyngeal Neoplasms* / pathology
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Staging
  • Prognosis
  • Prospective Studies
  • Radiotherapy, Intensity-Modulated* / adverse effects
  • Retrospective Studies