Multi-agent concurrent chemoradiotherapy for locally advanced head and neck squamous cell cancer in the elderly.
BACKGROUND
The reported decreasing benefit with increasing age from concurrent chemoradiotherapy in head and neck cancer patients prompted this retrospective review.


METHODS
Two courses of cisplatin-based concurrent chemoradiotherapy were given to fit patients ≥70 years with locoregionally advanced cancers. Clinical characteristics, treatment, and outcomes were compared with those for an identically treated cohort <70 years.


RESULTS
There were 44 patients ≥70 and 137 patients <70 years. Clinical characteristics, treatment and toxicities were similar except that the elderly were less likely to receive both chemotherapy courses, experienced more myelosuppression, required more unplanned hospitalization, and were feeding-tube dependent longer. Projected 5-year disease-specific survival (71% vs 74%) and freedom from recurrence (69% v. 71%) were nearly identical.


CONCLUSIONS
Although these selected elderly patients experienced greater myelosuppression and supportive care requirements, outcomes were the same as in younger patients. Age alone should not be considered a contraindication to aggressive chemoradiotherapy for this disease.
Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, USA.
Stephanie A
SA
Michal
David J
DJ
Adelstein
Lisa A
LA
Rybicki
Cristina P
CP
Rodriguez
Jerrold P
JP
Saxton
Benjamin G
BG
Wood
Joseph
J
Scharpf
Denise I
DI
Ives
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001853:Bone Marrow / Q000528:radiation effects; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage; D004750:Enteral Nutrition / Q000706:statistics & numerical data; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D000077156:Gefitinib; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000453:epidemiology; D011799:Quinazolines / Q000008:administration & dosage; D011879:Radiotherapy Dosage; D012042:Registries; D012189:Retrospective Studies
D011799:Quinazolines; D002945:Cisplatin; D000077156:Gefitinib; D005472:Fluorouracil