title: Chemoradiotherapy in elderly patients with advanced head and neck cancer under intensive nutritional support.
abstract: OBJECTIVE
  To evaluate treatment tolerance, toxicities and survival in elderly patients with advanced head and neck cancer who received inpatient-based intensive nutritional support with concurrent chemoradiotherapy in comparison with younger patients undergoing the same treatment.
  
  
  METHODS
  We retrospectively analyzed the records of 126 stage III, IVA and IVB head and neck cancer patients who were treated with concurrent chemoradiotherapy between 2007 and 2009 under an inpatient-based nutritional support program. The clinical characteristics, treatment tolerance, toxicities and survival of patients older than 65 years were compared with those of identically treated patients younger than 65 years.
  
  
  RESULTS
  There were 21 patients older than 65 years and 105 patients younger than 65 years. Clinical characteristics and treatment toxicities were similar between the groups, except that the elderly were less likely to tolerate cisplatin, experienced more weight loss, required more feeding tube support and tended to have >grade 3 hematological toxicities and to develop sepsis during the period of chemoradiotherapy. The 1- and 2-year disease-free survival and disease-specific survival rates were nearly identical.
  
  
  CONCLUSIONS
  Age alone should not be considered a contraindication to aggressive chemoradiotherapy for advanced head and neck cancer. Older patients require more careful multidisciplinary assessment of their supportive care needs to ensure successful completion of treatment and avoid further treatment-related toxicity.
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, Taiwan.
authors.forename: Pei-Hung
authors.initials: PH
authors.lastname: Chang
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, Taiwan.
authors.forename: Kun-Yun
authors.initials: KY
authors.lastname: Yeh
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, Taiwan.
authors.forename: Jen-Seng
authors.initials: JS
authors.lastname: Huang
authors.affiliation: Department of Radiation Oncology, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, Taiwan.
authors.forename: Eric Yen-Chao
authors.initials: EY
authors.lastname: Chen
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, Taiwan.
authors.forename: Shih-Wei
authors.initials: SW
authors.lastname: Yang
authors.affiliation: Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Keelung and Chang Gung University, College of Medicine, Taiwan.|Cancer Center, Chang Gung Memorial Hospital, Keelung, Taiwan.
authors.forename: Cheng-Hsu
authors.initials: CH
authors.lastname: Wang
mesh_terms: D000328:Adult; D059248:Chemoradiotherapy / Q000379:methods*; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018529:Nutritional Support / Q000379:methods*; D012189:Retrospective Studies; D016019:Survival Analysis
keywords: chemoradiation; elderly; head and neck cancer; nutrition; survival