Practice patterns and outcomes of chemoradiotherapy versus radiotherapy alone for older patients with nasopharyngeal cancer

Older patients are at increased risk of toxicities from aggressive oncologic therapy and of nononcologic death. A meta‐analysis of non‐nasopharyngeal head and neck cancers showed no statistical benefit in adding chemotherapy to radiotherapy (RT) in older patients; another meta‐analysis of RT versus...

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Bibliographic Details
Published in:Cancer medicine (Malden, MA) MA), 2018-05, Vol.7 (5), p.1604-1611
Main Authors: Verma, Vivek, Surkar, Swati M., Moreno, Amy C., Lin, Chi, Simone, Charles B.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Cancer
Cancer therapies
Chemoradiotherapy
Chemoradiotherapy - adverse effects
Chemoradiotherapy - methods
Chemotherapy
Clinical Cancer Research
elderly
Female
geriatric
Head & neck cancer
Head and neck
Humans
Male
Multivariate analysis
nasopharyngeal cancer
Nasopharyngeal Neoplasms - pathology
Nasopharyngeal Neoplasms - therapy
nasopharynx
Neoplasm Grading
Neoplasm Staging
Original Research
Practice Patterns, Physicians
Proportional Hazards Models
Radiation therapy
Radiotherapy - methods
Sex Factors
Survival
Survival Analysis
Throat cancer
Toxicity
Treatment Outcome
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Summary:Older patients are at increased risk of toxicities from aggressive oncologic therapy and of nononcologic death. A meta‐analysis of non‐nasopharyngeal head and neck cancers showed no statistical benefit in adding chemotherapy to radiotherapy (RT) in older patients; another meta‐analysis of RT versus chemoradiotherapy (CRT) in NPC found advantages to CRT, but vastly under‐represented patients ≥70 years old. This is the largest study to date evaluating outcomes of CRT versus RT alone in this population. The National Cancer Data Base (NCDB) was queried for primary nasopharyngeal cancer cases (2004–2013) in patients ≥70 years old receiving RT alone or CRT. Patients with unknown RT/chemotherapy and T1N0 or M1 disease were excluded. Logistic regression analysis ascertained factors associated with CRT delivery. Kaplan–Meier analysis evaluated overall survival (OS) between both cohorts. Cox proportional hazards modeling determined variables associated with OS. In total, 930 patients were analyzed (n = 713 (77%) CRT, n = 217 (23%) RT). Groups were relatively balanced; CRT was less frequently delivered in patients with advancing age, lower nodal burden, and females (P 
ISSN:2045-7634
2045-7634
DOI:10.1002/cam4.1290