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Treatment tolerability and outcomes in elderly patients with head and neck cancer
Author(s) -
Dickstein Daniel R.,
Egerman Marc,
Monrose Erica,
Varma Achintya,
Ozbek Umut,
Sharma Sonam,
Liu Jerry T.,
Gupta Vishal,
Posner Marshall R.,
Misiukiewicz Krzysztof,
Miles Brett A.,
Genden Eric,
Bakst Richard L.
Publication year - 2021
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.26548
Subject(s) - medicine , tolerability , interquartile range , head and neck cancer , head and neck squamous cell carcinoma , cohort , clinical trial , oncology , population , cohort study , cancer , surgery , adverse effect , environmental health
Abstract Purpose The number of elderly patients with head and neck squamous cell carcinoma (HNSCC) continues to grow. Management of this cohort remains poorly defined. We investigated treatment tolerability and clinical outcomes in this underrepresented population. Methods We identified patients aged ≥70 with nonrecurrent, nonmetastatic HNSCC treated curatively from 2007‐2018 and analyzed clinical covariates. Results Two hundred and twenty patients with a median age of 75 (interquartile range:72‐80) were identified. Age and comorbidities were not correlated with toxicity ( P ≥ .05). Patients who experienced a treatment interruption had significantly greater weight loss ( P = .042) and worse overall survival (OS) ( P < .001), but not worse disease‐specific survival ( P = .45), or locoregional control ( P = .21). Conclusions Treatment interruptions were associated with weight loss and worse OS, but not disease related outcomes, suggesting an interruption in the elderly may be a surrogate for another issue. In sum, our data should guide clinical trial design to benefit this growing, neglected cohort.