The impact of age on outcome in phase III NRG Oncology/RTOG trials of radiotherapy (XRT) plus / minus; systemic therapy in locally advanced head and neck cancer

摘要

Purpose: To examine the role age plays in the treatment and prognosis of locally advanced head and neck cancer (LAHNC) treated definitively with radiation alone or combined modality therapy. Methods: A retrospective analysis was performed of three NRG/RTOG trials examining either radiation alone or combined radiation and systemic therapy for LAHNC. The effect of age ( 0.001). For OS, the HR for patients age 0.001). After adjustment for all covariates, age -70 was associated with worse OS regardless of adjustment for smoking and p16 status. The survival difference was more pronounced in those receiving combined radiation and systemic therapy. Hematologic and renal toxicities were increased in combined modality trials in patients >-70 years old. Conclusions: Patients age >-70 with LAHNC were underrepresented in these clinical trials. Their CSS and OS proved inferior to patients <70 years old. (c) 2021 Elsevier Ltd. All rights reserved.