In:
Asia-Pacific Journal of Clinical Oncology, Wiley, Vol. 14, No. 3 ( 2018-06), p. 247-255
Abstract:
Definitive chemoradiotherapy (CRT) is the standard treatment for locally advanced head and neck cancer (HNC). However, for very elderly patients, the comparison of benefit/risk between definitive radiotherapy (RT) with and without systemic chemotherapy was equivocal. Patients and methods The study was a single‐institute, retrospective, cohort study. Seventy patients aged ≥75 years who had a locally advanced HNC were enrolled. The patients were divided into those with CRT and those with RT alone. Survival, compliance/adverse events and independent prognostic factors were analyzed. Results For baseline characteristics, the patients who received RT alone had worse performance status, comorbidity score and neutrophil‐to‐lymphocyte ratio. However, during definitive therapy, the CRT group had more adverse events such as neutropenia, febrile neutropenia and thrombocytopenia. There were no significant differences in disease‐specific survival (DSS) and overall survival (OS) ( P = 0.864 and 0.788, respectively). As to OS, several independent prognostic factors were identified. Performance status (hazard ratio [HR], 2.312; confidence interval [CI] , 1.176–4.546; P = 0.015), clinical T staging (HR, 2.240; 95% CI, 1.021–4.913; P = 0.004) and total RT dose (HR, 2.555; 95% CI, 1.246–5.238; P = 0.010) were independent prognostic factors of OS. Conclusions Definitive RT with or without systemic chemotherapy did not significantly influence DSS and OS for very elderly patients. Therefore, for elderly patients aged ≥ 75 years who have HNC, conservative RT might be sufficient for treatment purposes.
Type of Medium:
Online Resource
ISSN:
1743-7555
,
1743-7563
DOI:
10.1111/ajco.2018.14.issue-3
Language:
English
Publisher:
Wiley
Publication Date:
2018
detail.hit.zdb_id:
2187409-8
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