Efficacy of chemoradiotherapy in elderly patients with stage IV inoperable head and neck cancer

• Published in: European archives of oto-rhino-laryngology 2024-11, Vol.281 (11), p.5931-5945
• Main Authors: Zhu, Runqiu, Wang, Pan, Dai, Jiahui, Cheng, Yangxi, Zhu, Huiyong
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Chemoradiotherapy - methods; Female; Head and Neck; Head and Neck Neoplasms - mortality; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - therapy; Head and Neck Surgery; Humans; Kaplan-Meier Estimate; Male; Medicine; Medicine & Public Health; Neoplasm Staging; Neurosurgery; Otorhinolaryngology; Propensity Score; Proportional Hazards Models; Retrospective Studies; SEER Program; Survival Rate; Treatment Outcome
• ISSN: 0937-4477; 1434-4726; 1434-4726
• DOI: 10.1007/s00405-024-08805-8

Objectives This study aimed to compare the efficacy of chemoradiotherapy (CRT) with radiotherapy (RT) alone for elderly patients (≥ 65 years) with stage IV inoperable head and neck cancer (IV-HNC). Methods Elderly patients diagnosed with inoperable IV-HNC from 2010 to 2015 were identified using the SEER database. Then, we performed a 1:1 propensity-score matched (PSM) analysis to reduce treatment selection bias, and the prognostic role of CRT was investigated using Kaplan-Meier analysis, log-rank test, and Cox proportional hazard models. The main outcome was overall survival (OS), and the secondary outcome was cancer-specific survival (CSS). Results A total of 3318 patients were enrolled, of whom 601 received RT alone and 2717 received CRT. Through PSM, 526 patients were successfully matched, and balances between the two treatment groups were reached. In the matched dataset, multivariable Cox analysis revealed that CRT was associated with better OS (HR = 0.580, P