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
4596 - A Phase 2, Open-Label, Randomized, Multicenter Trial of Encorafenib + Binimetinib Evaluating a Standard-dose and a High-dose Regimen in Patients With BRAFV600-Mutant Melanoma Brain Metastasis (MBM) (POLARIS)
Presenter: Michael Davies
Session: Poster Display session 3
Resources:
Abstract
1891 - Continuation of annual screening mammograms and breast-cancer mortality in women over 70
Presenter: Xabier Garcia De Albeniz
Session: Poster Display session 3
Resources:
Abstract
5587 - Introducing standardized medical procedure and dynamic decision support program in precision oncology for the community of practice
Presenter: Istvan Petak
Session: Poster Display session 3
Resources:
Abstract
4757 - Effectively using primary care givers in oncology care through capacity building, task sharing and techno-mentoring.
Presenter: Dinesh Pendharkar
Session: Poster Display session 3
Resources:
Abstract
4497 - A single institution review of capecitabine related acute admissions and cost analysis
Presenter: Gemma Dart
Session: Poster Display session 3
Resources:
Abstract
2187 - Health status of middle-aged and older cancer survivors in China: results from the China Health and Retirement Longitudinal Study (CHARLS)
Presenter: Jiarui Li
Session: Poster Display session 3
Resources:
Abstract
5101 - Crossed looks on lung cancer perception and knowledge from general public and physicians in France: results of a two-fold survey
Presenter: Céline Mascaux
Session: Poster Display session 3
Resources:
Abstract
4354 - Knowledge and perception of clinical trials (CTs) and attitude towards participation among Polish oncological patients - A pilot survey
Presenter: Artur Kotowski
Session: Poster Display session 3
Resources:
Abstract
3499 - Achieving best possible cancer treatment outcomes in care pathways through benchmarking; ABC-Benchmarking
Presenter: Anke Wind
Session: Poster Display session 3
Resources:
Abstract
2270 - Impact of 10-day Fulbright Specialist Program (FSP) and Project Pink Blue (PPB) Education Sessions on Medical Oncology knowledge among Doctors that treat cancer in Nigeria
Presenter: Mike Martin
Session: Poster Display session 3
Resources:
Abstract