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Published in: International Journal of Clinical Oncology 3/2024

29-12-2023 | Cytostatic Therapy | Original Article

Radiotherapy with or without chemotherapy for locally advanced head and neck cancer in elderly patients: analysis of the Head and Neck Cancer Registry of Japan

Authors: Koichi Yasuda, Yusuke Uchinami, Satoshi Kano, Jun Taguchi, Daisuke Kawakita, Megumi Kitayama, Kentaro Nishioka, Takashi Mori, Fuki Koizumi, Yuri Fujii, Yasushi Shimizu, Keiji Kobashi, Seiichi Yoshimoto, Ken-ichi Nibu, Akihiro Homma, Hidefumi Aoyama

Published in: International Journal of Clinical Oncology | Issue 3/2024

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Abstract

Background

Whether concurrent chemotherapy with radiotherapy (CRT) is effective for elderly patients with head and neck cancer is a controversial topic. This study aimed to analyze the effectiveness of CRT vs. radiation therapy (RT) among elderly patients in Japan.

Methods

Data from the Head and Neck Cancer Registry of Japan were extracted and analyzed. Patients with locally advanced squamous cell carcinoma of the oropharynx, hypopharynx, or larynx who received definitive CRT or RT between 2011 and 2014 were included.

Results

CRT was administered to 78% of the 1057 patients aged ≥ 70 years and 67% of the 555 patients aged ≥ 75 years. For the patients aged ≥ 75 years, the overall survival (OS) rate was significantly better in the CRT group than in the RT group (P < 0.05), while the progression-free survival (PFS) rate was not significantly different (P > 0.05). The add-on effect of CRT was significantly poor in elderly patients (P < 0.05), and it was not a significant factor in the multivariate analysis for patients aged ≥ 75 years. After propensity score matching, there were no significant differences in the OS and PFS rates between the patients aged ≥ 70 years and those aged ≥ 75 years (all, P > 0.05).

Conclusion

Although aggressive CRT is administered to elderly patients in Japan, its effectiveness is uncertain. Further prospective randomized trials are needed to verify whether CRT is superior to RT alone for elderly patients.
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Metadata
Title
Radiotherapy with or without chemotherapy for locally advanced head and neck cancer in elderly patients: analysis of the Head and Neck Cancer Registry of Japan
Authors
Koichi Yasuda
Yusuke Uchinami
Satoshi Kano
Jun Taguchi
Daisuke Kawakita
Megumi Kitayama
Kentaro Nishioka
Takashi Mori
Fuki Koizumi
Yuri Fujii
Yasushi Shimizu
Keiji Kobashi
Seiichi Yoshimoto
Ken-ichi Nibu
Akihiro Homma
Hidefumi Aoyama
Publication date
29-12-2023
Publisher
Springer Nature Singapore
Published in
International Journal of Clinical Oncology / Issue 3/2024
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-023-02450-7

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