Increased acute mortality with chemoradiotherapy for locally advanced head and neck cancer in patients ≥70years

• Published in: Journal of geriatric oncology 2017-01, Vol.8 (1), p.50-55
• Main Authors: Strom, Tobin J, Naghavi, Arash O, Trotti, Andy M, Russell, Jeffery, Kish, Julie A, McCaffrey, Judith, Otto, Kristen J, Harrison, Louis B, Caudell, Jimmy J
• Format: Article
• Language: English
• Subjects: Adult; Age; Age Factors; Aged; Aged, 80 and over; Antineoplastic Agents - therapeutic use; Carboplatin - therapeutic use; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - therapy; Chemoradiotherapy; Chemotherapy; Cisplatin - therapeutic use; Deglutition Disorders; Elderly; Female; Head and neck; Head and Neck Neoplasms - mortality; Head and Neck Neoplasms - therapy; Hospitalization - statistics & numerical data; Humans; LAHNC; Logistic Models; Male; Middle Aged; Mortality; Multivariate Analysis; Proportional Hazards Models; Radiation; Radiotherapy; Radiotherapy, Intensity-Modulated - methods; Retrospective Studies; Squamous Cell Carcinoma of Head and Neck; Survival; Survival Rate; Toxicity
• ISSN: 1879-4068; 1879-4076
• DOI: 10.1016/j.jgo.2016.09.003

Concurrent chemoradiotherapy (CRT) is the standard of care for many sites of locally advanced head and neck squamous cell carcinomas (LAHNC). However, on meta-analysis, the addition of chemotherapy did not improve survival for patients >70years. We hypothesized that elderly patients treated with CRT would have increased toxicity without similar improvements in survival. A single-institution, IRB-approved retrospective study took place from 2005 to 2012 including 369 patients treated with CRT for LAHNC. Multivariate models for death at 3months and death over time were developed using logistic regression and Cox modeling, respectively. Patients ≥70years were treated less often with concurrent cisplatin dosed every 3weeks (25.5% vs. 71.4%, respectively) and more often with weekly carboplatin (31.9% vs. 3.4%) than patients