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ePoster Display

875P - Definitive chemo-IMRT in locally advanced head and neck squamous cell carcinoma (LAHN-SCC): An experience with geriatric patients

Date

16 Sep 2021

Session

ePoster Display

Topics

Cytotoxic Therapy;  Cancer in Older Adults;  Radiation Oncology

Tumour Site

Head and Neck Cancers

Presenters

Imtiaz Ahmed

Citation

Annals of Oncology (2021) 32 (suppl_5): S786-S817. 10.1016/annonc/annonc704

Authors

I. Ahmed1, S. Krishnamurthy1, R. Bhise2, K. Vinchurkar3, M. Kalloli3, M.V. Jali4

Author affiliations

  • 1 Radiation Oncology, KLES Belgaum Cancer Hospital, 590010 - Belgaum/IN
  • 2 Medical Oncology, KLES Belgaum Cancer Hospital, 590010 - Belgaum/IN
  • 3 Surgical Oncology, KLES Belgaum Cancer Hospital, 590010 - Belgaum/IN
  • 4 Incharge Director, KLES Belgaum Cancer Hospital, 590010 - Belgaum/IN

Resources

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Abstract 875P

Background

Geriatric patients with LAHN-SCC are under-represented in clinical trials and denied standard treatment with concurrent chemo-radiation. Most are treated with radiotherapy (RT) alone. However, with the use of intensity modulated radiotherapy (IMRT) and good supportive care, even this cohort of patients can be considered for chemo-radiation.

Methods

69 patients with age >65 years with LA-HNSCC treated between April 2015 and December 2019 in our Institute were retrospectively evaluated for treatment compliance and outcomes. All patients were planned to receive 70Gy in 33-35 fractions with simultaneous integrated boost -IMRT and concurrent weekly cisplatin at a dose of 40mg/m2 or carboplatin AUC 2. Overall survival (OS) and prognostic factors were evaluated using SPSS version 16.

Results

Median age at presentation was 67 years (65-81). 54 were male. 63.7% had KPS of >90. Primary site of presentation were oropharynx (29), hypopharynx (27) and larynx (13). 12 (17.3%) had co-morbid conditions. Primary tumour status: T2/T3/T4 - 14/46/8; Nodal status: N0/N1/N2/N3 – 16/23/27/3. 37 (53.6%) had stage III disease. Median baseline haemoglobin was 12g/dl (7.5-18). 5 had feeding tube and 3 had tracheostomy tube. All patients completed planned 70 Gy in 33-35 fractions. 44 received cisplatin and 25 received carboplatin. 56 (81%) of patients received at least 5 (>200mg/m2) or more chemotherapy cycles, median of 6 cycles. Median overall treatment time was 50 days (42-65 days). Grade 3 toxicity was seen only as neutropenia/mucositis/laryngitis/pharyngitis in 5.7%/16%/4.3%/14.4%, respectively. Mean weight loss was 8.7% (0-17%). Overall response rate was 97.1%, 44 (63.7%) had complete response. With median follow up of 23.6 months (3-71), OS was 53.5%. Estimated 3-year and 5-year OS were 41.3% and 34.3%, respectively. On univariate analysis age less than 70 years, use of cisplatin, N0-N1, stage III and complete response to treatment showed good OS (p value <0.05). On multivariate analysis only age (p =0.03) and complete response to treatment had good OS (p =0.00). Four patients developed second primary cancer.

Conclusions

Definitive chemo-IMRT approach in Geriatric LAHN-SCC is well tolerated with acceptable clinical outcomes.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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