Influence of gender and age on the survival of patients with nasopharyngeal carcinoma

Abstract

BackgroundThe prognostic value of gender and age in the survival of nasopharyngeal carcinoma (NPC) patients treated with intensity-modulated radiotherapy (IMRT) is unclear. Several studies have suggested a female advantage in the prognosis of solid tumors. We investigated the relationship between gender differences and disease outcome in NPC patients treated with IMRT in South China.MethodsA total of 299 patients with non-disseminated NPC were analyzed retrospectively. IMRT was delivered with a simultaneous modulated, accelerated radiotherapy boost technique at prescribed doses of 70 Gy/30 fractions/6 weeks to the primary tumor (GTVp) and positive neck nodes (GTVn), 60Gy (2.0 Gy/day) to the clinical target volume (CTV) and upper neck region and 54 Gy (1.8 Gy/day) to the clinically negative low neck. A median boost dose of 9.2 Gy (4–20 Gy) was administered to patients with persistent disease at the primary site.ResultsWith a median follow-up of 52 months, the male patients had a significantly unfavorable 5-year OS (70.7% compared to 94.1%, P < 0.001), DPFS (71.5% compared to 87.3%, P = 0.029) and DMFS (77.2% compared to 89.7%, P = 0.036) than the female patients. In patients younger than 45, the male patients had a poorer 5-year OS (66.8% compared to 91.2%, P = 0.008), DPFS (59.9% compared to 91.2%, P = 0.005) and DMFS (66.4% compared to 94.0%, P = 0.004) than the female patients. For patients older than 45, only the 5-year OS (72.2% compared to 96.0%, P = 0.001) was significantly different.ConclusionsGender and age are strong independent prognostic factors for NPC in this study. We are the first to report that younger male patients were more likely to have distant metastases and exhibited inferior overall survival and disease progression-free survival rates compared to other patients.

Age at diagnosis indicated poor prognosis in locoregionally advanced nasopharyngeal carcinoma

“…Our finding was highly consistent with prior reports in [7,8] and out of [16,17] clinical trials. However, age showed no association with survival in another two trials that focused on the effect of concurrent chemotherapy [10] and adjuvant chemotherapy [9] respectively.…”

Development and external validation of nomograms predictive of response to radiation therapy and overall survival in nasopharyngeal cancer patients

“…Several studies were reported about age as a prognostic factor in NPC [32][33][34][35][36]. Many of these indicated that younger age was related with favourable outcomes, but others reported that the disease course in younger patients was poorer than that in old patients [36,37].…”

Nasopharyngeal Carcinoma: A 15 Year Study with Respect to Clinicodemography and Survival Analysis

“…Also the patients with intracranial extension had low overall survival which is turn depicts the advanced stage of disease. The prognostic role of age and gender on the survival of NPC was seen in the study of Xiao et al [22] where in younger men were more likely to have distant metastases and exhibited inferior overall survival and disease progression-free survival rates.…”