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Characteristics and treatment patterns in older patients with locally advanced head and neck cancer (KCSG HN13-01)

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Author(s)
Eun Joo KangYun-Gyoo LeeBhumsuk KeamJin-Hyuk ChoiJin-Soo KimKeon Uk ParkKyoung Eun LeeHyo Jung KimKeun-Wook LeeMin Kyoung KimHee Kyung AhnSeong Hoon ShinJii Bum LeeJung Hye KwonHye Ryun KimSung-Bae KimHwan Jung Yun
Keimyung Author(s)
Park, Keon Uk
Department
Dept. of Internal Medicine (내과학)
Journal Title
Korean J Intern Med
Issued Date
2022
Volume
37
Issue
1
Keyword
AgedHead and neck neoplasmsTherapeutics
Abstract
Background/Aims:
Treatment decisions for locally advanced head and neck squamous cell carcinoma (LA-HNSCC) are complicated, and multi-modal treatments are usually indicated. However, it is challenging for older patients to complete treatments. Thus, we investigated disease characteristics, real-world treatment, and outcomes in older LA-HNSCC patients.

Methods:
Older patients (aged ≥ 70 years) were selected from a large nationwide cohort that included 445 patients with stage III–IVB LA-HNSCC from January 2005 to December 2015. Their data were retrospectively analyzed and compared with those of younger patients.

Results:
Older patients accounted for 18.7% (83/445) of all patients with median age was 73 years (range, 70 to 89). Proportions of primary tumors in the hypopharynx and larynx were higher in older patients and older patients had a more advanced T stage and worse performance status. Regarding treatment strategies of older patients, 44.5% of patients received concurrent chemoradiotherapy (CCRT), 41.0% underwent surgery, and 14.5% did not complete the planned treatment. Induction chemotherapy (IC) was administered to 27.7% (23/83) of older patients; the preferred regimen for IC was fluorouracil and cisplatin (47.9%). For CCRT, weekly cisplatin was prescribed 3.3 times more often than 3-weekly cisplatin (62.2% vs. 18.9%). Older patients had a 60% higher risk of death than younger patients (hazard ratio, 1.6; p = 0.035). Oral cavity cancer patients had the worst survival probability.

Conclusions:
Older LA-HNSCC patients had aggressive tumor characteristics and received less intensive treatment, resulting in poor survival. Further research focusing on the older population is necessary.
Keimyung Author(s)(Kor)
박건욱
Publisher
School of Medicine (의과대학)
Citation
Eun Joo Kang et al. (2022). Characteristics and treatment patterns in older patients with locally advanced head and neck cancer (KCSG HN13-01). Korean J Intern Med, 37(1), 190–200. doi: 10.3904/kjim.2020.636
Type
Article
ISSN
2005-6648
Source
https://www.kjim.org/journal/view.php?number=170638
DOI
10.3904/kjim.2020.636
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44011
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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