Objectives: This study aimed to assess the effect of definitive or adjuvant concurrent chemoradiation (CRT) among elderly patients with locally advanced head and neck squamous cell carcinoma (LA HNSCC). Materials and Methods: We retrospectively analyzed 150 elderly LA HNSCC patients (age ≥70) at a single institution. Demographics, disease control outcomes, and toxicities with different chemotherapy regimens were reviewed. The Kaplan-Meier method was used to estimate progression-free survival (PFS) and overall survival (OS) estimates. Results: Median age at diagnosis was 74 years (range 70–88). Of the cohort, 98 (65.3%) patients received definitive and 52 (34.7%) received adjuvant CRT; 44 (29.3%) patients received weekly carboplatin and paclitaxel, 43 (28.7%) weekly cetuximab, 33 (22%) weekly carboplatin, and 30 (20%) weekly cisplatin. The OS at 2 years was 70% (95% confidence interval [CI]: 63–79%), and PFS at 2 years was 61% (95% CI: 53–70%). There was no significant difference in OS or PFS between definitive and adjuvant CRT (p = 0.867 and p = 0.475, respectively). Type of chemotherapy regimen (single-agent carboplatin vs. others) (95% CI: 1.1–3.9; p = 0.009) was a key prognostic factor in predicting OS in multivariable analysis. Concurrent use of cetuximab was associated with increased risk of PEG tube dependence at 6 months (p #x3c; 0.001). Conclusions: Management of LA HNSCC in the elderly is a challenging scenario. Our study shows that CRT is a feasible treatment modality for elderly patients with LA HNSCC. We recommend CRT with weekly cisplatin or weekly carboplatin and paclitaxel. A chemotherapy regimen should be carefully selected in this difficult to treat population.
Oncol Res Treat

中文翻译：

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接受不同放化疗的老年人头颈癌患者的治疗结果：单中心经验

目的：本研究旨在评估确定性或辅助同步放化疗（CRT）对局部晚期头颈部鳞状细胞癌（LA HNSCC）老年患者的影响。材料和方法：我们回顾性分析了一个机构的 150 名老年 LA HNSCC 患者（年龄≥70 岁）。回顾了人口统计学、疾病控制结果和不同化疗方案的毒性。Kaplan-Meier 方法用于估计无进展生存期 (PFS) 和总生存期 (OS) 估计值。结果：诊断时的中位年龄为 74 岁（范围 70-88）。在队列中，98 名 (65.3%) 患者接受了明确的 CRT，52 名 (34.7%) 接受了辅助 CRT；44 (29.3%) 名患者每周接受卡铂和紫杉醇治疗，43 (28.7%) 名患者每周接受西妥昔单抗治疗，33 (22%) 名患者每周接受卡铂治疗，30 (20%) 名患者每周接受顺铂治疗。2 年 OS 为 70%（95% 置信区间 [CI]：63-79%），2 年 PFS 为 61%（95% CI：53-70%）。确定性 CRT 和辅助 CRT 之间的 OS 或 PFS 没有显着差异（分别为p = 0.867 和p = 0.475）。化疗方案类型（单药卡铂与其他）（95% CI：1.1-3.9；p= 0.009) 是多变量分析中预测 OS 的关键预后因素。同时使用西妥昔单抗与 6 个月时对 PEG 管依赖的风险增加相关（p #x3c；0.001）。结论：老年人 LA HNSCC 的管理是一个具有挑战性的场景。我们的研究表明 CRT 是老年 LA HNSCC 患者可行的治疗方式。我们推荐 CRT 每周一次顺铂或每周一次卡铂和紫杉醇。在这个难以治疗的人群中，应仔细选择化疗方案。
肿瘤资源治疗