Characteristics and treatment patterns in older patients with locally advanced head and neck cancer (KCSG HN13-01)

Eun Joo Kang, Yun Gyoo Lee, Bhumsuk Keam, Jin Hyuk Choi, Jin Soo Kim, Keon Uk Park, Kyoung Eun Lee, Hyo Jung Kim, Keun Wook Lee, Min Kyoung Kim, Hee Kyung Ahn, Seong Hoon Shin, Jii Bum Lee, Jung Hye Kwon, Hye Ryun Kim, Sung Bae Kim, Hwan Jung Yun

Research output: Contribution to journalArticlepeer-review

Abstract

Background/Aims: Treatment decisions for locally advanced head and neck squamous cell carcinoma (LA-HNSCC) are complicated, and multi-modal treatments are usually indicated. However, it is challenging for older patients to complete treatments. Thus, we investigated disease characteristics, real-world treatment, and outcomes in older LA-HNSCC patients. Methods: Older patients (aged ≥ 70 years) were selected from a large nationwide cohort that included 445 patients with stage III–IVB LA-HNSCC from January 2005 to December 2015. Their data were retrospectively analyzed and compared with those of younger patients. Results: Older patients accounted for 18.7% (83/445) of all patients with median age was 73 years (range, 70 to 89). Pro-portions of primary tumors in the hypopharynx and larynx were higher in older patients and older patients had a more advanced T stage and worse performance status. Regarding treatment strategies of older patients, 44.5% of patients received concurrent chemoradiotherapy (CCRT), 41.0% underwent surgery, and 14.5% did not complete the planned treatment. Induction chemotherapy (IC) was administered to 27.7% (23/83) of older patients; the preferred regimen for IC was fluoro-uracil and cisplatin (47.9%). For CCRT, weekly cisplatin was prescribed 3.3 times more often than 3-weekly cisplatin (62.2% vs. 18.9%). Older patients had a 60% higher risk of death than younger patients (hazard ratio, 1.6; p = 0.035). Oral cavity cancer patients had the worst survival probability. Conclusions: Older LA-HNSCC patients had aggressive tumor characteristics and received less intensive treatment, resulting in poor survival. Further research focusing on the older population is necessary.

Original languageEnglish
Pages (from-to)190-200
Number of pages11
JournalKorean Journal of Internal Medicine
Volume37
Issue number1
DOIs
StatePublished - Jan 2022

Keywords

  • Aged
  • Head and neck neoplasms
  • Therapeutics

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