The prognostic significance of comorbidity in patients with locoregionally advanced, inoperable squamocellular head and neck cancers

[M. V. Kreačić]

90 listova

Onkologija - Medikalna onkologija / Oncology - Medical oncology

U savremenom dobu personalizovane medicine, faktori prognoze vezani za pacijenta potvrdili su svoj značaj u smislu boljeg terapijskog planiranja i preciznije procene preživljavanja. U bolesnika sa malignim bolestima često se javljaju druga oboljenja ili stanja,nevezana za sam tumor koja se zajednički nazivaju komorbiditetom. Zahvaljujući činjenici da poznati rizikofaktori za nastanak planocelularnih karcinoma glave i vrata kao što su zloupotreba duvana i alkohola mogu dovesti do oštećenja drugih važnih organa, bolesnici sa ovom vrstom tumora pogodni su za analizu uticaja komorbidnih stanja na prognozu maligne bolesti. Cilj rada je procena prevalence komorbiditeta i najčešćih komorbidnih stanja kao i njihovog uticaja na prognozu preživljavanja u ovoj populaciji bolesnika. Materijal i metode U periodu od jula 2002.g do januara 2007.g 100 bolesnika sa lokoregionalno uznapredovalim,inoperabilnim, planocelularnim karcinomima glave i vrata lečeno je na Institutu za Onkologiju i Radiologiju Srbije neoadjuvantnom hemioterapijom u sastavu Citarabin-5 fluorouracil-Cispaltina. Medijana starosne dobi obolelih bila je 55 godina,najvećim delom muškarci (91%), sa prosečnim brojem primenjenih hemioterapijskih ciklusa od 4. Podaci o komorbidnim stanjima prikupljani su prospektivno korišćenjem različitih izvora podataka i to pre početka samog lečenja. Za procenu ozbiljnosti komorbidnih stanja korišćen je ACE-27 komorbidni indeks sa četvorostepenom skalom (0-3). Prosečno vreme praćenja bolesnika iznosilo je 15 meseci sa rasponom od 3 do 59 meseci...

In present era of personalized medicine prognostic factors related to patients regained its importance in respecct to bettter treatment planning and more accurate prediction of survival.Patients with tumours often have other diseases or conditions in addition to their index cancer which are generally referred to as comorbidities.Due to the fact that well known risk factors for development of HNSCC such as tobacco and alcohol abuse can also damage other important organs,patients with this type of cancer are suitable for analysing the influence of comorbid conditions on prognosis of the disease. Aim of our work is to assess the prevalence of comorbidities,most frequent conditions and prognostic impact on overall survival in this particular population. Matherial and methods Between July 2002 and January 2007 in Institute for oncology and radiology of Serbia, 100 patients with locoregionally advanced inoperable HNSCC were initially treated with neoadjuvant chemotherapy regimen Cytarabine-5 Fluorouracil-Cisplatinum. Median age of patients was 55 years,most of them males (91%) with median number of applied chemo cycles being 4. Data on comorbidity were collected in prospective manner from various sources prior to treatment. For grading of the severity of comorbid conditions, ACE-27 comorbidity index was used with four degree scale (O-3) . The average follow-up of patients was 15 months with range from 3-59 months. Results Comorbidity was present in 69 pts (69%),and 31 pts (31%) had no comorbidities prior to treatment. Among pts with comorbid conditions prevail alcoholics,active and former (71%),pts with chronic lung diseases (25%) and cardiovascular diseases(18%)...

Komorbiditet, karcinomi glave i vrata, lokoregionalno uznapredovala bolest, hemioterapija, prognoza

Comorbidity, head and neck cancers, locoregionally advanced disease, chemotherapy, prognosis

616-006.6-036.7(043.3)

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