Outcomes in patients age 70 and above treated with radical radiotherapy for Head & Neck Cancer


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Saurabh Borgaonkar1,Lisa Hay1,Claire Paterson1,Derek Grose1,Carolynn Lamb1,Stephano Schipani1,Christina Wilson1,Allan James1,Maureen Thomson1
1Beatson

Abstract

Background

 Radical radiotherapy (RT) for head and neck (H&N) cancer results in significant acute and late toxicity. Concerns about the ability of even carefully selected older patients to tolerate this treatment and the impact it may have on their functioning post treatment prompted this review of practice.  Outcomes in patients aged 70 or above who received RT for treatment of a squamous cell carcinoma (SCC) of the H&N at the Beatson West of Scotland Cancer Centre were evaluated.

Method

Data was retrospectively collected for patients treated consecutively between January 2012 and August 2015. 148 patients met the inclusion criteria; aged 70 or above, treated with radical radiotherapy either adjuvantly or primarily.  

Clinical information was gained from the trusts electronic patient record system and the statistical programme (STATA) was used to generate descriptive statistics.

Results

Patient characteristics are shown in table 1.  53(36%) patients had primary surgery. 8(5%) patients failed to complete RT. 57(39%) patients are alive to date. Twelve months post RT 107(72%) patients residence was at their home.

61(41%) patients experienced a relapse of their H&N disease. The mean number of days to relapse was 373 (SD 369 days). 72(49%) patients had a hospital admission within 6 months following RT.  The mean number of days admitted to hospital in 12 months following RT was 12 days (SD 24 days). 57(39%) patients died of their cancer. 108(73%) patients final residence post RT was their own home address.

Median patient survival was 38 months (95% CI 27.2-45.5 months). Patient survival was also further stratified by age (>75 or 70 to 75) and stage of tumour at diagnosis.

Conclusion

This data provides reassurance that radical radiotherapy remains a feasible option in the elderly with Head and Neck cancers and that the current selection of older patients consenting for radical radiotherapy is acceptable.