Addition of Chemotherapy Improves Survival in Some Elderly Patients with Head and Neck Cancer

The addition of chemotherapy to radiation therapy (chemoradiation) improves survival among a subset of elderly patients with advanced head and neck cancer.  These results were recently presented at the 2016 annual Multidisciplinary Head and Neck Cancer Symposium.

The addition of chemotherapy (CT) to radiation therapy (RT) improves survival rates among a subset of elderly head and neck cancer patients, specifically those ages 71 to 79 with low comorbidity scores and advanced disease stage, according to research presented at the 2016 Multidisciplinary Head and Neck Cancer Symposium.

Globally, head and neck cancer comprises the seventh most common type of cancer with an estimated 400,000-600,000 diagnoses every year.  Standard treatment for advanced head and neck often includes a combination of chemotherapy, radiation and/or surgery.  However elderly patients diagnosed with the disease, as well as those who have significant additional medical conditions (co-morbidities), are often not offered chemotherapy as part of their treatment regimen due to their perceived inability to safely tolerate its side effects.

Results from studies evaluating optimal treatment approaches for the elderly in head and neck cancer have involved older chemotherapy agents and radiation techniques, which often were associated with more severe side effects, coupled with less effective supportive care.

Researchers recently evaluated data from the National Cancer Database of patients 70 years and older cancer to gain a better understanding of how newer treatment options affected the elderly with advanced head and neck cancer. Patients in the study were treated between 1998 and 2011.  Although patients had advanced cancer, it had not spread to distant sites in the body.  Some patients had been treated with chemoradiation, and some had only received radiation therapy.

  • Overall survival was improved with the addition of chemotherapy to radiation, compared to radiation only, among patients who were 79 years and younger; had few co-morbidities; and had more advanced cancers.
  • The addition of chemotherapy to radiation did not improve survival, compared to radiation only, among patients who were 80 years and older; had more co-morbidities; and had earlier-stage cancers.

The researchers stated that elderly patients aged 79 years and younger, those with few co-morbidities and those with more advanced stages of head and neck cancer (excluding cancer spread to distant sites), derive a significant survival benefit from the addition of chemotherapy to radiation therapy.

 

Reference: Amini A, Jones  B, McDermott J, et al. DOI: http://dx.doi.org/10.1016/j.ijrobp.2015.12.035

Does Age Matter? Survival Outcomes With the Addition of Concurrent Chemotherapy for Elderly Head and Neck Cancer Patients Undergoing Definitive Radiation Using the National Cancer Data Base. International Journal of Radiation Oncology • Biology • Physics 2016; 94(4): p871.

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