Alexander Rühle1,2, Sofie Rothhaar1, Erik Haehl1,2, Tobias Kalckreuth1,2, Tanja Sprave1,2, Raluca Stoian1,2, Constantinos Zamboglou1,2, Eleni Gkika1,2, Andreas Knopf3, Anca-Ligia Grosu1,2, Nils H Nicolay4,5. 1. Department of Radiation Oncology, University of Freiburg-Medical Center, Robert-Koch-Str. 3, 79106, Freiburg, Germany. 2. German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (Dkfz), Neuenheimer Feld 280, 69120, Heidelberg, Germany. 3. Department of Otorhinolaryngology, University of Freiburg - Medical Center, Killianstr. 5, 79106, Freiburg, Germany. 4. Department of Radiation Oncology, University of Freiburg-Medical Center, Robert-Koch-Str. 3, 79106, Freiburg, Germany. nils.nicolay@uniklinik-freiburg.de. 5. German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (Dkfz), Neuenheimer Feld 280, 69120, Heidelberg, Germany. nils.nicolay@uniklinik-freiburg.de.
Abstract
PURPOSE: This study analyzed survival and toxicity after (chemo)radiotherapy for primary salivary gland cancer patients aged ≥ 65 years and compared these results with younger patients using a matched-pair analysis. METHODS: Twenty-nine elderly patients with primary salivary gland carcinomas treated with (chemo)radiotherapy from 2008 to 2020 at University of Freiburg Medical Center were analyzed for oncological outcomes and therapy-associated toxicities. Local/locoregional control (LRC), progression-free survival (PFS) and overall survival (OS) were calculated using the Kaplan-Meier method, and the influence of clinical parameters on patient outcomes was assessed. A matched-pair analysis was performed after matching with patients < 65 years. RESULTS: Nine patients (31.0%) received definitive (chemo)radiotherapy, and 20 patients (69.0%) were treated in the adjuvant setting. 2-year LRC, PFS and OS ranged at 82.4%, 53.7% and 71.8%, respectively. Smoking (HR 3.980, p = 0.020), reduced performance status (HR 3.735, p = 0.016) and higher comorbidity burden (HR 4.601, p = 0.005) correlated with inferior OS. Using a matched-pair analysis with younger patients, elderly patients exhibited a trend towards reduced OS (HR 3.015, p = 0.065), but not PFS (HR 1.474, p = 0.371) or LRC (HR 1.324, p = 0.633). Acute and chronic grade 3 toxicities occurred in 31.0% and 12.5% of elderly patients, respectively, and the matched-pair analysis revealed no significant differences between age groups regarding treatment-related toxicities. CONCLUSION: Treatment-related toxicities as well as LRC and PFS were comparable for salivary gland cancer patients undergoing radiotherapy. Therefore, concerns for more pronounced toxicities or reduced local/locoregional response rates should not guide treatment decisions in affected elderly patients.
PURPOSE: This study analyzed survival and toxicity after (chemo)radiotherapy for primary salivary gland cancerpatients aged ≥ 65 years and compared these results with younger patients using a matched-pair analysis. METHODS: Twenty-nine elderly patients with primary salivary gland carcinomas treated with (chemo)radiotherapy from 2008 to 2020 at University of Freiburg Medical Center were analyzed for oncological outcomes and therapy-associated toxicities. Local/locoregional control (LRC), progression-free survival (PFS) and overall survival (OS) were calculated using the Kaplan-Meier method, and the influence of clinical parameters on patient outcomes was assessed. A matched-pair analysis was performed after matching with patients < 65 years. RESULTS: Nine patients (31.0%) received definitive (chemo)radiotherapy, and 20 patients (69.0%) were treated in the adjuvant setting. 2-year LRC, PFS and OS ranged at 82.4%, 53.7% and 71.8%, respectively. Smoking (HR 3.980, p = 0.020), reduced performance status (HR 3.735, p = 0.016) and higher comorbidity burden (HR 4.601, p = 0.005) correlated with inferior OS. Using a matched-pair analysis with younger patients, elderly patients exhibited a trend towards reduced OS (HR 3.015, p = 0.065), but not PFS (HR 1.474, p = 0.371) or LRC (HR 1.324, p = 0.633). Acute and chronic grade 3 toxicities occurred in 31.0% and 12.5% of elderly patients, respectively, and the matched-pair analysis revealed no significant differences between age groups regarding treatment-related toxicities. CONCLUSION: Treatment-related toxicities as well as LRC and PFS were comparable for salivary gland cancerpatients undergoing radiotherapy. Therefore, concerns for more pronounced toxicities or reduced local/locoregional response rates should not guide treatment decisions in affected elderly patients.
Entities:
Keywords:
Chemoradiotherapy; Elderly patients; Head-and-neck cancer; Radiotherapy; Salivary gland cancer
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