Concurrent chemoradiotherapy for head and neck cancers in older patients: Outcomes and their determinants

INTRODUCTION: Meta-analyses have shown concurrent chemoradiotherapy (CCRT) provides no survival benefit over radiotherapy in patients of head and neck squamous cell carcinoma (HNSCC) aged over 70 years. This study was performed to determine the adverse-effect profile, compliance, functional and onco...

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Published in:Indian journal of cancer 2019-07, Vol.56 (3), p.261-266
Main Authors: Srinivasalu, Vijay, Subramaniam, Narayana, Balasubramanian, Deepak, Kumar, Narender, Philip, Arun, Susan, Annu, Pushpaja, K, Nair, Anoop, Thankappan, Krishnakumar, Jose, Wesley, Iyer, Subramania, Keechilat, Pavithran
Format: Article
Language:English
Subjects:
Age groups
Cancer
Cancer patients
Cancer research
Cancer therapies
Carboplatin
Carcinoma
Care and treatment
Chemotherapy
Elderly patients
Head & neck cancer
Head and neck cancer
Hydration
Life expectancy
Mortality
Oncology
Patient compliance
Patients
Physiology
Pneumonia
Radiation therapy
Radiotherapy
Squamous cell carcinoma
Type 2 diabetes
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Summary:INTRODUCTION: Meta-analyses have shown concurrent chemoradiotherapy (CCRT) provides no survival benefit over radiotherapy in patients of head and neck squamous cell carcinoma (HNSCC) aged over 70 years. This study was performed to determine the adverse-effect profile, compliance, functional and oncological outcomes in patients of HNSCC over 70 years of age treated with CCRT. MATERIALS AND Methods: Retrospective analysis of stage III/IV HNSCC in patients above 70 years of age who received CCRT at our institution (n = 57). Cox-proportional hazards regression model was used for statistical analysis. RESULTS: There were 57 patients of stage III/IV HNSCC who underwent curative CCRT. 61% completed chemotherapy with no deaths and acceptable toxicity. The predictors of recurrence were poorer performance status (P = 0.031) and treatment breaks (P = 0.04). Tube dependence was associated with 2.7 times higher risk of mortality (P = 0.005). CONCLUSION: CCRT should be considered standard of care in those over seventy with good performance status. Patients with tube dependence have a higher risk of persistent disease or treatment related mortality.
ISSN:0019-509X
1998-4774
DOI:10.4103/ijc.IJC_725_18