부산대학교 도서관

Purpose/objective(s): The management of elderly patients with squamous cell carcinoma (HNSCC) of the head and neck presents unique challenges. We examined the radiation therapy (RT) management and outcomes of a large-scale registry population spanning 10 years. We hypothesize that there is no significant difference in the overall survival (OS) of elderly patients with HNSCC who received conventionally fractionated (CF) RT compared to hypofractionated (HF) RT.Materials/methods: 1029 HNSCC patients (> 70 yo) treated with definitive RT from 2007-2017 were identified from the provincial registry. Patient characteristics were analyzed in relationship to HF and CF RT. KM analysis was carried out for OS.Results: 264 (26%) and 765 (74%) were female and male, respectively. 427 (41%) were 70-74 yo, 297 (29%) were 75-79, and the remainder were > 80 yo. Stages included were: I (200 (19%)), II (192 (19%)), III (146 (14%)), IV (366 (36%)). ECOG were: 0/1 (347 (34%)), 2/3 (142 (14%)), unknown 542 (53%). Sites were: oropharynx 379 (37%), larynx 366 (36%), oral cavity 230 (22%), other 56 (5%). Patients were more likely to be aged 70-74, have stage IV disease, and present with laryngeal or oropharyngeal cancer (P < 0.0001). 578 (56%) and 451 (44%) received HF and CF, respectively. Median RT dose was 6000 cGy (range 200-7400). Median OS was 48 months for both HF and CF (P = 0.9). A poorer performance status (2 vs 0 (HR 2.095 (CI 1.5-2.9)), 3 vs 0 (HR 2.89 (CI 2-4.2)) (P < 0.0001)), increasing age (80-84 (HR 1.5 (CI 1.2-1.9)), 85-89 (HR 1.7 (CI 1.2-2.4)), 90-94 (HR 2.7 (CI 1.8-4.2)) (P < 0.0001)), advanced stage (Stage II HR 1.4 (CI 1.1-1.9) (P = 0.0064), Stage III HR 1.6 (CI 1.2-2.2) (P = 0.0011), Stage IV HR 2.5 (CI 1.9-3.3) (P < 0.0001)), and oral cavity (HR 1.5 (CI 1.3-1.9) (P < 0.0001)) were prognostic for increased risk of death. HF vs CF was not statistically significant for a difference in OS.Conclusion: There was no significant difference in OS between HF and CF RT in elderly patients with HNSCC. Real world data suggests that HF regimens are a feasible RT option that reduces the number and frequency of hospital visits and the total treatment duration, which is of particular interest during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]