Radiotherapy/Chemoradiotherapy for Geriatric Head and Neck Cancer Patients

INTRODUCTION: In our study, it was aimed to analyze radiotherapy (RT) compliance, acute toxicity results, and survival in geriatric patients with head and neck cancers.
METHODS: In our study, 77 geriatric patients (≥ 70 years) underwent curative RT diagnosed with head and neck cancer between 04.05.2010 and 24.03.2022 in the Radiation Oncology Clinic of Ankara Bilkent City Hospital and Ankara Atatürk Training and Research Hospital were analyzed. The study’s primary outcome was RT completion, interruption, and acute adverse events. The study’s secondary endpoint was evaluating overall survival (OS) and progression-free survival (PFS).
RESULTS: The median follow-up period of the study was 10 (range 1-130) months. The median age of the patients at the time of RT was 75 years. (Range 70-86). Most patients were diagnosed with laryngeal cancer (n=35, 45.5%). Of the 77 patients in our study, 71 (92.2%) completed their treatment, and 6 (7.8%) could not complete the radiotherapy course. Patients who could not complete the planned radiotherapy scheme were mostly diagnosed with laryngeal and hypopharyngeal cancer. (p=0.036; OR 1.94 95%CI 0.33-11.30). 71 patients completed treatment, and 67 (94.4%) did not interrupt treatment. In contrast, the treatment had to be interrupted for the last 4 (5.6%) patients. Grade 3 side effects were observed in 6 patients (7.8%). No grade 4 side effects were observed. During the follow-up period, 16 (20.8%) patients died; 61 (79.2%) were alive. Median OS was 9.8 (range 1 to 130) months. There was a significant relationship between OS and primary (p=0.035). Hypopharyngeal patients were significantly lower; nasopharyngeal and nasal cavity tumors have higher OS values. Local recurrence was observed in 6 (7.3%) of the patients and the median PFS was 8.9 (range 1-130) months.
DISCUSSION AND CONCLUSION: In patients over 70 with head and neck cancer, definitive chemoradiotherapy (CRT) is a feasible treatment with acceptable toxicity.