Characteristics and treatment patterns in older patients with locally advanced head and neck cancer (KCSG HN13-01)
- Author:
Eun Joo KANG
1
;
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
Author Information
- Publication Type:2
- From:The Korean Journal of Internal Medicine 2022;37(1):190-200
- CountryRepublic of Korea
- Language:English
-
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). Proportions 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 fluorouracil 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.
