Sheela Hanasoge1,2, Kelly R Magliocca3, Jeffrey M Switchenko4,2, Nabil F Saba5,2, J Trad Wadsworth6, Mark W El-Deiry6, Dong M Shin5,2, Fadlo Khuri5,2, Jonathan J Beitler1,2, Kristin A Higgins1,2. 1. Department of Radiation Oncology, Emory University, Atlanta, Georgia. 2. Winship Cancer Institute, Atlanta, Georgia. 3. Department of Pathology, Emory University, Atlanta, Georgia. 4. Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia. 5. Department of Hematology and Medical Oncology, Emory University, Atlanta, Georgia. 6. Department of Otolaryngology - Head and Neck Surgery, Emory University, Atlanta, Georgia.
Abstract
BACKGROUND: The benefit of combined chemoradiation in elderly patients with human papillomavirus (HPV)-positive locally advanced oropharyngeal squamous cell carcinoma (SCC) must be balanced with the potential for higher toxicity rates. We performed a retrospective review of our institutional experience. METHODS: Patients 70 years or older with p16-positive oropharyngeal SCC treated with definitive chemoradiation from 2005 to 2013 were evaluated. Overall survival (OS), disease-free survival (DFS), and locoregional failure-free survival were calculated. RESULTS: Twenty-one eligible patients had a follow-up of 22.4 months. Estimated 5-year OS, DFS, and locoregional failure-free survival were 76.0%, 40%, and 95%, respectively. There was 1 death from acute toxicity, and 50% had unplanned hospitalizations. Sixty percent had late toxicity, and 6-month feeding tube dependence was 25%. CONCLUSION: Elderly patients with HPV-positive locally advanced SCC of the oropharynx treated with definitive chemoradiation had good OS but high rates of acute and long-term toxicity.
BACKGROUND: The benefit of combined chemoradiation in elderly patients with human papillomavirus (HPV)-positive locally advanced oropharyngeal squamous cell carcinoma (SCC) must be balanced with the potential for higher toxicity rates. We performed a retrospective review of our institutional experience. METHODS:Patients 70 years or older with p16-positive oropharyngeal SCC treated with definitive chemoradiation from 2005 to 2013 were evaluated. Overall survival (OS), disease-free survival (DFS), and locoregional failure-free survival were calculated. RESULTS: Twenty-one eligible patients had a follow-up of 22.4 months. Estimated 5-year OS, DFS, and locoregional failure-free survival were 76.0%, 40%, and 95%, respectively. There was 1 death from acute toxicity, and 50% had unplanned hospitalizations. Sixty percent had late toxicity, and 6-month feeding tube dependence was 25%. CONCLUSION: Elderly patients with HPV-positive locally advanced SCC of the oropharynx treated with definitive chemoradiation had good OS but high rates of acute and long-term toxicity.
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