Survival Patterns in Elderly Head and Neck Squamous Cell Carcinoma Patients Treated With Definitive Radiation Therapy

Sommers, L.; Steenbakkers, Roel J.H.M.; Bijl, H.P.; Hoek, J.G.M. Vemer-van den; Roodenburg, Jan; Oosting, Sjoukje F.; Halmos, György B.; Rooij, Sophia E. de; Langendijk, Johannes A.

doi:10.1016/j.ijrobp.2017.02.214

Cited by 20 publications

(23 citation statements)

References 23 publications

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“…On multivariate analysis, older age was associated with increased early mortality and is correlated with increasing comorbidities, which we were not able to account for in our study. These are similar findings to a study by Sommers et al assessing overall survival after definitive RT for head and neck cancer in elderly patients . Patients with oral cavity cancers had a higher risk of early mortality relative to those with oropharynx cancers.…”

Section: Discussionsupporting

confidence: 90%

“…These are similar findings to a study by Sommers et al assessing overall survival after definitive RT for head and neck cancer in elderly patients. 29 Patients with oral cavity cancers had a higher risk of early mortality relative to those with oropharynx cancers. Similar findings have been seen in SEER population-based analysis, particularly for the oral tongue subsite.…”

Section: Multivariate and Recursive Partitioning Analysismentioning

confidence: 99%

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Early (90‐day) mortality after radical radiotherapy for head and neck squamous cell carcinoma: A population‐based analysis

et al. 2018

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Background A retrospective, population‐based analysis of 90‐day mortality in patients with squamous cell carcinoma of the head and neck treated with radiotherapy was performed to determine the early mortality rate and associated risk factors. Methods Data were abstracted for all consecutive patients with cancer of the head and neck treated from 1998 to 2014 at the BC Cancer Agency with curative intent radiotherapy (n = 5658). Logistic regression analysis was used to determine factors associated with early mortality. Results The median age at diagnosis was 63 years. The mortality rate at 90 days after starting radiotherapy (RT) was 3.6% (n = 203/5658). The cause of death was attributed to head and neck cancer for 81% of patients. Multivariate analysis demonstrated that increasing age, oral cavity subsite, and advanced T and N classification were associated with an increased risk of early mortality (p < .05). Conclusions The risk of early mortality was 3.6%. Elderly patients with advanced T and N classification had the highest risk of early mortality.

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Section: Discussionsupporting

confidence: 90%

Section: Multivariate and Recursive Partitioning Analysismentioning

confidence: 99%

Early (90‐day) mortality after radical radiotherapy for head and neck squamous cell carcinoma: A population‐based analysis

et al. 2018

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“…5,[28][29][30] Given the clinical evidence and study limitations, we reasoned that prescribing aggressive CCRT to all patients with locally advanced HNSCC, including those with severe underlying diseases, might be inappropriate and dangerous because of the increased risk of treatment-related toxic effects. 5,6,24,31 Notably, age and comorbid diseases are 2 independent prognostic factors strongly associated with survival, mainly because of an increase in noncancer-related mortality and severe underlying diseases. 31 However, current data regarding the differences in cancer-specific survival in various comorbid profiles as well as between young and elderly patients are scarce.…”

Section: Discussionmentioning

confidence: 99%

“…5,6,24,31 Notably, age and comorbid diseases are 2 independent prognostic factors strongly associated with survival, mainly because of an increase in noncancer-related mortality and severe underlying diseases. 31 However, current data regarding the differences in cancer-specific survival in various comorbid profiles as well as between young and elderly patients are scarce. 31 In addition, the suitability of active surveillance or RT alone as less toxic therapeutic alternatives to the commonly prescribed CCRT in some specific patients with locally advanced HNSCC has not been addressed, to our knowledge.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Predictive Scoring System for 90-Day Mortality Among Patients With Locally Advanced Head and Neck Squamous Cell Carcinoma Who Have Completed Concurrent Chemoradiotherapy

et al. 2020

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IMPORTANCEThere is currently no system to predict 90-day morality among patients with locally advanced head and neck squamous cell carcinoma (HNSCC) after the completion of concurrent chemoradiotherapy (CCRT). OBJECTIVETo validate the accuracy of a predictive scoring system for 90-day mortality among patients with locally advanced HNSCC who have completed CCRT. DESIGN, SETTING, AND PARTICIPANTSThis prognostic study included 16 029 patients with HNSCC who completed CCRT between January 2006 and December 2015. Data were extracted from the Taiwan Cancer Registry Database. A risk scoring system was developed based on significant risk factors and corresponding risk coefficients. Data analysis was conducted from June 2018 to February 2019. EXPOSURES Mortality within 90 days of completion of definitive CCRT. MAIN OUTCOMES AND MEASURESThe 90-day mortality rate after completion of CCRT and the accuracy of the scoring system, based on a comparison of mortality rates between training and test data sets. RESULTS Among 16 029 patients with locally advanced HNSCC, 1068 (6.66%; 1016 [95.1%] men; mean [SD] age, 55.11 [11.45] years) died before reaching the 90-day threshold, and 14 961 (93.4%; 14 080 [94.1%] men; mean [SD] age, 52.07 [9.99] years) survived. Multivariable analysis revealed that being aged 50 years or older (adjusted hazard ratio [aHR], 1.263; 95% CI, 1.104-1.445; P < .001),

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“…Elderly patients are in general likely to receive less intensive treatment than their younger counterparts, 9,10 and have less favorable survival outcomes. 11 Some authors have expressed concerns that this subgroup of patients may be undertreated. 9 There is a need for further evidence to guide decision making in this challenging group of patients.…”

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confidence: 99%

Outcomes for elderly patients 75 years and older treated with curative intent radiotherapy for mucosal squamous cell carcinomas of the head and neck

et al. 2019

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Background: Elderly patients with mucosal squamous cell carcinomas of the head and neck (mHNSCC) represent a challenging clinical dilemma. Methods: A retrospective review was performed of patients ≥75 years, treated with curative-intent radiotherapy for mHNSCC in two quaternary Sydney hospitals between 2007 and 2017. Results: Ninety-five patients met inclusion criteria. The median age was 79 years (75-94). Patients received radiotherapy alone (n = 24), concurrent chemoradiotherapy (n = 22), surgery and adjuvant radiotherapy (n = 45), or surgery with adjuvant chemoradiotherapy (n = 4). Median follow-up was 4.5 years, median overall survival (OS) was 3.8 years, and 2-year and 5-year OS were 56% and 43%, respectively. Eastern Cooperative Oncology Group performance status of ≥2 (P < .001) was a statistically significant predictor of reduced OS. Thirty-four patients (36%) required hospitalization, 5 (5%) did not complete radiotherapy, and 9 (9%) were feeding tube dependent beyond 6 months. Conclusions: Appropriately selected elderly patients can achieve durable outcomes from curative intent radiotherapy with acceptable treatment toxicity. K E Y W O R D Selderly, geriatric oncology, head and neck cancer, performance status, radiotherapy

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Survival Patterns in Elderly Head and Neck Squamous Cell Carcinoma Patients Treated With Definitive Radiation Therapy

Cited by 20 publications

References 23 publications

Early (90‐day) mortality after radical radiotherapy for head and neck squamous cell carcinoma: A population‐based analysis

Early (90‐day) mortality after radical radiotherapy for head and neck squamous cell carcinoma: A population‐based analysis

Assessment of Predictive Scoring System for 90-Day Mortality Among Patients With Locally Advanced Head and Neck Squamous Cell Carcinoma Who Have Completed Concurrent Chemoradiotherapy

Outcomes for elderly patients 75 years and older treated with curative intent radiotherapy for mucosal squamous cell carcinomas of the head and neck

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