Frontiers in Oncology (Feb 2021)
Prognostic Factors Predict Oncological Outcome in Older Patients With Head and Neck Cancer Undergoing Chemoradiation Treatment
- Carmen Stromberger,
- Carmen Stromberger,
- Berna Yedikat,
- Berna Yedikat,
- Annekatrin Coordes,
- Annekatrin Coordes,
- Ingeborg Tinhofer,
- Ingeborg Tinhofer,
- Ingeborg Tinhofer,
- Ingeborg Tinhofer,
- Goda Kalinauskaite,
- Goda Kalinauskaite,
- Volker Budach,
- Volker Budach,
- Volker Budach,
- Volker Budach,
- Sebastian Zschaeck,
- Sebastian Zschaeck,
- Jan-Dirk Raguse,
- Jan-Dirk Raguse,
- Grzegorz Kofla,
- Grzegorz Kofla,
- Max Heiland,
- Max Heiland,
- Aksana Stsefanenka,
- Aksana Stsefanenka,
- Benedicta Beck-Broichsitter,
- Benedicta Beck-Broichsitter,
- Steffen Dommerich,
- Steffen Dommerich,
- Carolin Senger,
- Carolin Senger,
- Marcus Beck,
- Marcus Beck
Affiliations
- Carmen Stromberger
- Department of Radiation Oncology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Carmen Stromberger
- Berlin Institute of Health (BIH), Berlin, Germany
- Berna Yedikat
- Department of Radiation Oncology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Berna Yedikat
- Berlin Institute of Health (BIH), Berlin, Germany
- Annekatrin Coordes
- Berlin Institute of Health (BIH), Berlin, Germany
- Annekatrin Coordes
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Ingeborg Tinhofer
- Department of Radiation Oncology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Ingeborg Tinhofer
- Berlin Institute of Health (BIH), Berlin, Germany
- Ingeborg Tinhofer
- German Cancer Research Center (DKFZ), Heidelberg, Germany
- Ingeborg Tinhofer
- German Cancer Consortium (DKTK) partner site Berlin, Berlin, Germany
- Goda Kalinauskaite
- Department of Radiation Oncology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Goda Kalinauskaite
- Berlin Institute of Health (BIH), Berlin, Germany
- Volker Budach
- Department of Radiation Oncology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Volker Budach
- Berlin Institute of Health (BIH), Berlin, Germany
- Volker Budach
- German Cancer Research Center (DKFZ), Heidelberg, Germany
- Volker Budach
- German Cancer Consortium (DKTK) partner site Berlin, Berlin, Germany
- Sebastian Zschaeck
- Department of Radiation Oncology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Sebastian Zschaeck
- Berlin Institute of Health (BIH), Berlin, Germany
- Jan-Dirk Raguse
- Berlin Institute of Health (BIH), Berlin, Germany
- Jan-Dirk Raguse
- Department of Oral and Maxillofacial Surgery, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Grzegorz Kofla
- Berlin Institute of Health (BIH), Berlin, Germany
- Grzegorz Kofla
- Department of Oncology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Max Heiland
- Berlin Institute of Health (BIH), Berlin, Germany
- Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Aksana Stsefanenka
- Department of Radiation Oncology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Aksana Stsefanenka
- Berlin Institute of Health (BIH), Berlin, Germany
- Benedicta Beck-Broichsitter
- Berlin Institute of Health (BIH), Berlin, Germany
- Benedicta Beck-Broichsitter
- Department of Oral and Maxillofacial Surgery, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Steffen Dommerich
- Berlin Institute of Health (BIH), Berlin, Germany
- Steffen Dommerich
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Carolin Senger
- Department of Radiation Oncology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Carolin Senger
- Berlin Institute of Health (BIH), Berlin, Germany
- Marcus Beck
- Department of Radiation Oncology, Charité–Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
- Marcus Beck
- Berlin Institute of Health (BIH), Berlin, Germany
- DOI
- https://doi.org/10.3389/fonc.2020.566318
- Journal volume & issue
-
Vol. 10
Abstract
PurposeOlder patients with head and neck cancer (HNC) represent a challenging group, as frailty and comorbidities need to be considered. This study aimed to evaluate the efficacy and side effects of curative and palliative (chemo) radiation ([C]RT) with regard to basic geriatric screening in older patients.MethodsThis study included HNC patients aged ≥70 years who were treated with curative or palliative (C)RT. Clinicopathological data including Charlson Comorbidity Index (CCI), Karnofsky performance status (KPS), and treatment data were analyzed as predictors of overall survival (OS).ResultsA total of 271 patients (median age, 74 years) were enrolled. The majority had UICC stage III/IV (90%) and underwent curative treatment (85.2%). A total of 144 (53.1%) patients received definitive and 87 (32.1%) had adjuvant (C)RT. Overall, 40 patients (14.8%) received palliative (C)RT. Median follow-up duration (curative setting) was 87 months, and the 2- and 5-year OS rates were 57.8 and 35.9%, respectively. Median OS was significantly different for age ≤75 vs. >75 years, CCI <6 vs. ≥6, KPS ≥70 vs. <70%, Tx/T1/T2 vs. T3/T4, and adjuvant vs. definitive (C)RT, respectively. Age 70–75 years (p = 0.004), fewer comorbidities when CCI < 6 (p = 0.014), good KPS ≥ 70% (p = 0.001), and adjuvant (C)RT (p = 0.008) independently predicted longer survival. Palliative RT resulted in a median OS of 4 months.ConclusionOlder age, lower KPS, higher CCI, and definitive (C)RT are indicators of worse survival in older patients with HNC treated curatively. Without a comprehensive geriatric assessment in patients aged >75 years, the KPS and CCI can be useful tools to account for “fitness, vulnerability or frailty” to help in treatment decision-making.
Keywords
- head and neck cancer (HNC)
- head and neck squamous cell carcinoma (HNSCC)
- older patients
- head and neck cancer
- survival
- chemoradiation
