Abstract 1478
Background
Concurrent chemoradiation (CRT) improves survival in squamous cell carcinoma of the head and neck (HNSCC). Little is known about the outcomes of elderly patients (pts, ≥70 years old) in terms of treatment efficacy and side effects. This retrospective study compares acute toxicity, response to therapy, and overall survival between elderly pts receiving different CRT combinations.
Methods
Pts. without dementia, deficit on instrumental activities of daily living, Charlson comorbidity index <2, and living at home with a family member received CRT. Pts received one of the following: 1) weekly carboplatin AUC 1 and paclitaxel 30mg/m2 for seven doses (CP), 2) cetuximab loading dose of 400 mg/m² followed by 250 mg/m² weekly for seven doses (CE), 3) weekly carboplatin AUC 1.5 for seven doses (CB), 4) weekly cisplatin 40 mg/m2 for seven doses (CIS). Radiation was administered to a dose of 70 Gy as definitive treatment or 66 Gy as adjuvant treatment (2 Gy/fraction).
Results
150 pts. (M/F: 111/39) with mean age 74.6 (range 70-88) were identified. 52 pts (34.7%) received adjuvant and 98 (65.3%) definitive CRT. Tumor site: oropharynx 74 (49.5%), oral cavity (17.5%), larynx 14%, others (19%). 60 pts (40%) were p-16 positive. 44 patients (29.5%) received CP, 43 (28.5%) CE 33 (22%) CB, and 30 (20%) CIS. 110 pts (73.5%) had a complete response (CR). 90 pts (60%) were admitted to the hospital during CRT, and pneumonia was the most common diagnosis (59 pts, 39.5%). 98 pts (65.5%) had percutaneous endoscopic gastrostomy tube (PEG) due to G3 mucositis. Two patients (1.3%) experienced G5 cardiovascular toxicity. At 6 months, 38 (25.3%) still had PEG, and was associated with CRT regimen (p = 0.001): 6/44(14%) received CP, 22/43 (51%) CE, 4/33 (12%) CB, and 6/30 (20%) CIS. The overall survival at 3 yrs was 60% (95% confidence interval (CI), 52%-71%). The predictors for OS at 3 yrs were response to therapy (CR 78% (68%-88%), and non-CR 17% (7%-37%); P < 0.0001), and CRT regimen (CB 41% (25%- 66%) vs others 66%, (57%- 78%); P = 0.01).
Conclusions
CRT can be administered to a selected elderly population with HNSCC. Single agent CB was associated with worse outcomes. CE seems to be related to a higher rate of long term PEG dependence.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The Ohio State University, James Cancer Hospital and Solove Research Institute.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3290 - Identification of meningioma patients in high risk of tumor recurrence using microRNA profiling
Presenter: Josef Srovnal
Session: Poster Display session 3
Resources:
Abstract
2477 - Antecedent of cancer and mortality after the first ST segment elevation acute myocardial infarction treated with primary coronary angioplasty. A prospective cohort study
Presenter: Irene Sillero
Session: Poster Display session 3
Resources:
Abstract
1894 - Genomic characterisation of locally advanced pancreatic adenocarcinoma
Presenter: Sarah Picardo
Session: Poster Display session 3
Resources:
Abstract
3280 - Comparison of freshly prepared and frozen cells from colorectal cancer surgical samples for phenotyping experiments- a pilot study
Presenter: Sandra Mersakova
Session: Poster Display session 3
Resources:
Abstract
3419 - Hyaluronan (HA) Accumulation in the Tumor Microenvironment (TME) is Increased in Colorectal Cancer (CRC) and Associated with Consensus Molecular Subtypes (CMS) 4 Molecular Subtype
Presenter: Barbara Blouw
Session: Poster Display session 3
Resources:
Abstract
1833 - Evaluation of CT-based radiomics in patients with renal cell carcinoma
Presenter: An Zhao
Session: Poster Display session 3
Resources:
Abstract
5883 - Detection of Double Protein Expression in Diffuse Large B Cell Lymphoma
Presenter: Mohamed Gouda
Session: Poster Display session 3
Resources:
Abstract
5415 - Encyclopedic Tumor Analysis for organ agnostic treatment with Axitinib in combination regimens for advanced cancers
Presenter: Tim Crook
Session: Poster Display session 3
Resources:
Abstract
3297 - Computational model to predict response rate of clinical trials
Presenter: Orsolya Lorincz
Session: Poster Display session 3
Resources:
Abstract
4355 - Analysis of BRCA genes and homologous recombination deficiency (HRD) scores in tumours from patients (pts) with metastatic breast cancer (mBC) in the OlympiAD trial
Presenter: Mark Robson
Session: Poster Display session 3
Resources:
Abstract