Different definitive radiotherapy approaches in indian elderly head and neck cancer patients: Experience from an Indian Center

Abstract

Introduction: Treatment of Squamous Cell Carcinoma of Head and Neck (SCCHN) in elderly age group is challenging. Role of either curative concurrent chemoradiation (ChTRT) or Accelerated Fractionation Radiotherapy(ACRT) in this subgroup is not clearly defined. Materials and Methods: Between July 2015 and December 2017, we treated 61 elderly (>70 years) SCCHN patients (excluding T1/T2N0M0 Ca Glottis). 18 patients had been excluded from analysis for 7 days). Complete response rate was better in ChTRT arm than others (94.4%, 80%, and 75%, respectively) Median progression-free survival (PFS) was better in ChTRT arm (5 months with a range of 3.4–6.6 months) than ACRT and RT only arm (both arms had median PFS of 3 months). Conclusion: All radical RT approaches are feasible and effective in Indian elderly SCCHN patients. Definitive ChTRT is better in terms of CR rate and PFS but with more acute toxicities. Radical treatment strategy of elderly should be guided by clinical judgments not by chronological age.

Keywords

• Elderly
• head and neck cancer
• radical radiotherapy