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Research article
Christoph Süß
Universitatsklinikum Regensburg
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background:
Radiotherapy and chemoradiation are well-established therapies for patients with squamous cell carcinoma of the head and neck (SCCHN). In aging societies, also the incidence of SCCHN in elderly patients is rising. Because of the underrepresentation of elderly patients in scientific trials, we evaluated the feasibility of adjuvant radiotherapy and chemoradiation in patients with SCCHN aged >70 years.
Methods:
All patients had been >70 years at the time of diagnosis and received adjuvant radiotherapy or, if feasible, chemoradiation at the University Medical Centre Regensburg between 2004 and 2018.
71 patients -most with SCCHN UICC stage IVa- with a median age of 75 years were included; 9 patients received concomitant chemoradiation. Median follow-up was 27 months (IQR 18 – 62 months).
Results:
Radiotherapy and chemoradiation was well tolerated. 62 patients (87.3%) underwent treatment without interruption, and 65 patients (91.5%) completed radiotherapy with 95% of the initially prescribed dose. Median dose for all patients was 64 Gy (IQR: 60 – 66 Gy). 6/9 patients received at least 75 % of the planned chemotherapy dose. 37 patients (52.1%) developed acute toxicity CTC grade III or IV.
Overall survival was 87 % after 12 months, 67 % after 24 months and 41 % after 60 months. Median overall survival was 51 months (IQR: 19 - 99 months). Local tumour control was 99 % after 12 months, 88 % after 24 months and 76 % after 5 years.
Conclusion:
Feasibility of adjuvant radiotherapy and chemoradiation in our collective of elderly patients with SCCHN was good. Particularly local tumour control was satisfactory. Overall survival does not seem to differ between elderly and younger patients or patients unselected for age. De-intensification of treatment because of age does not seem justified.
Keywords
Head and neck cancer, SCCHN, elderly patients, frail patients, radiotherapy, Karnofsky Performance Status, simultaneous chemoradiation
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research article
Christoph Süß
Universitatsklinikum Regensburg
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 06 Jul, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background:
Radiotherapy and chemoradiation are well-established therapies for patients with squamous cell carcinoma of the head and neck (SCCHN). In aging societies, also the incidence of SCCHN in elderly patients is rising. Because of the underrepresentation of elderly patients in scientific trials, we evaluated the feasibility of adjuvant radiotherapy and chemoradiation in patients with SCCHN aged >70 years.
Methods:
All patients had been >70 years at the time of diagnosis and received adjuvant radiotherapy or, if feasible, chemoradiation at the University Medical Centre Regensburg between 2004 and 2018.
71 patients -most with SCCHN UICC stage IVa- with a median age of 75 years were included; 9 patients received concomitant chemoradiation. Median follow-up was 27 months (IQR 18 – 62 months).
Results:
Radiotherapy and chemoradiation was well tolerated. 62 patients (87.3%) underwent treatment without interruption, and 65 patients (91.5%) completed radiotherapy with 95% of the initially prescribed dose. Median dose for all patients was 64 Gy (IQR: 60 – 66 Gy). 6/9 patients received at least 75 % of the planned chemotherapy dose. 37 patients (52.1%) developed acute toxicity CTC grade III or IV.
Overall survival was 87 % after 12 months, 67 % after 24 months and 41 % after 60 months. Median overall survival was 51 months (IQR: 19 - 99 months). Local tumour control was 99 % after 12 months, 88 % after 24 months and 76 % after 5 years.
Conclusion:
Feasibility of adjuvant radiotherapy and chemoradiation in our collective of elderly patients with SCCHN was good. Particularly local tumour control was satisfactory. Overall survival does not seem to differ between elderly and younger patients or patients unselected for age. De-intensification of treatment because of age does not seem justified.
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