Karam_Study Results_Survival Outcomes with Concurrent Chemoradiation for Locally Advanced Elderly Head and Neck Cancer Patients #hncs16 @ASTRO_org

Karam_Study Results_Survival Outcomes with Concurrent Chemoradiation for Locally Advanced Elderly Head and Neck Cancer Patients #hncs16 @ASTRO_org

ASTROHN2016

4 years
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4,042 patients were included: 2,538 (63%) received CRT. Median follow-up was 19 months. Unadjusted median OS was longer with the addition of CRT (p<0.001). OS was superior with CRT on MVA (HR, 0.63; 95% confidence interval [CI], 0.58-0.68; p<0.001) and PSM analyses (HR, 0.73; 95% CI, 0.66-0.80; p<0.001) compared to RT alone. Under RPA, CRT was associated with longer OS in patients < 81 years with low comorbidity scores and either T1- 2/N2-3 disease, or patients with T3-4/N0-3 disease. The survival benefit with CRT disappeared for two subgroups in the 71-80 age range: those with T1-2, N1, and CD0-1 and those with T3-4, N1+, and CD1+. Patients > 81 years did not have increased survival with CRT. Receipt of CRT was associated with longer duration of RT (odds ratio [OR], 1.81; 95% CI, 1.58-2.09; p<0.001). Conclusion(s): Patients > 70 should not be denied concurrent chemotherapy based solely on age; additional factors including performance status and tumor stage ought to be accounted for.
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