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Outcomes for elderly patients 75 years and older treated with curative intent radiotherapy for mucosal squamous cell carcinomas of the head and neck
Author(s) -
Horsley Patrick J.,
Perera Lakmalie,
Veness Michael J.,
Stevens Mark J.,
Eade Thomas N.,
Back Michael,
Brown Chris,
Jayamanne Dasantha T.
Publication year - 2020
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.25969
Subject(s) - medicine , radiation therapy , chemoradiotherapy , adjuvant radiotherapy , head and neck , surgery , feeding tube , retrospective cohort study , head and neck cancer , oncology
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.