Characteristics and treatment patterns in older patients with locally advanced head and neck cancer (KCSG HN13-01)
- 주제(키워드) Aged , Head and neck neoplasms , Therapeutics
- 주제(기타) Medicine, General & Internal
- 설명문(일반) [Kang, Eun Joo] Korea Univ, Dept Internal Med, Guro Hosp, Seoul, South Korea; [Lee, Yun-Gyoo] Sungkyunkwan Univ, Kangbuk Samsung Hosp, Dept Internal Med, Sch Med, Seoul, South Korea; [Keam, Bhumsuk] Seoul Natl Univ Hosp, Dept Internal Med, Seoul, South Korea; [Choi, Jin-Hyuk] Ajou Univ Hosp, Dept Hematol Oncol, Suwon, South Korea; [Kim, Jin-Soo] Seoul Metropolitan Govt Seoul Natl Univ, Dept Internal Med, Boramae Med Ctr, Seoul, South Korea; [Park, Keon Uk] Keimyung Univ, Dept Hematooncol, Dongsan Med Ctr, Daegu, South Korea; [Lee, Kyoung Eun] Ewha Womans Univ, Dept Hematol & Oncol, Mokdong Hosp, Seoul, South Korea; [Kim, Hyo Jung] Hallym Univ, Dept Internal Med, Sacred Heart Hosp, Anyang, South Korea; [Lee, Keun-Wook] Seoul Natl Univ, Dept Internal Med, Bundang Hosp, Seongnam, South Korea; [Kim, Min Kyoung] Yeungnam Univ, Dept Hematol Oncol, Med Ctr, Daegu, South Korea; [Ahn, Hee Kyung] Gachon Univ, Dept Internal Med, Gil Med Ctr, Incheon, South Korea; [Shin, Seong Hoon] Kosin Univ, Dept Internal Med, Gospel Hosp, Busan, South Korea; [Lee, Jii Bum; Kim, Hye Ryun] Yonsei Univ, Yonsei Canc Ctr, Dept Internal Med, Coll Med, Seoul, South Korea; [Kwon, Jung Hye; Yun, Hwan Jung] Chungnam Natl Univ Hosp, Dept Internal Med, 282 Munhwa Ro, Daejeon 35015, South Korea; [Kim, Sung-Bae] Univ Ulsan, Asan Med Ctr, Dept Internal Med, Coll Med, Seoul, South Korea
- 등재 SCIE, SCOPUS, KCI등재
- OA유형 Green Published, gold
- 발행기관 KOREAN ASSOC INTERNAL MEDICINE
- 발행년도 2022
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000190811
- 본문언어 영어
- Published As https://doi.org/10.3904/kjim.2020.636
- PubMed https://pubmed.ncbi.nlm.nih.gov/34929077
초록/요약
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.
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