Clinical outcomes in elderly patients with human papillomavirus-positive squamous cell carcinoma of the oropharynx treated with definitive chemoradiation therapy

• Type of Material: Article
• Authors: Sheela Hanasoge, Emory University; Kelly Magliocca, Emory University; Jeffrey Switchenko, Emory University; Nabil Saba, Emory University; Jeffery Wadsworth, Emory University; Mark El-Deiry, Emory University; Dong Shin, Emory University; Fadlo Khuri, Emory University; Jonathan Beitler, Emory University; Kristin Higgins, Emory University
• Language: English
• Date: 2016-07-30
• Publisher: Wiley: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2015 Wiley Periodicals, Inc.
• Final Published Version (URL): http://dx.doi.org/10.1002/hed.24073
• Title of Journal or Parent Work: Head and Neck
• ISSN: 1043-3074
• Volume: 38
• Issue: 6
• Start Page: 846
• End Page: 851
• Grant/Funding Information: Contract grant sponsor: Research reported in this publication was supported in part by the Biostatistics and Bioinformatics Shared Resource of the Winship Cancer Institute of Emory University and National Institutes of Health/National Cancer Institute under award number P30CA138292. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
• Keywords: UNITED-STATES; Life Sciences & Biomedicine; oropharyngeal cancer; OLDER; CONCURRENT CHEMORADIOTHERAPY; AGE; Otorhinolaryngology; chemoradiation; human papillomavirus-positive (HPV plus ); Surgery; NECK-CANCER; LOCALLY ADVANCED HEAD; elderly; SURVIVAL; Science & Technology
• Research Categories: Health Sciences, Pathology; Health Sciences, Oncology

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.