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Title: Patterns of Care in Elderly Head-and-Neck Cancer Radiation Oncology Patients: A Single-Center Cohort Study

Abstract

Purpose: To compare the patterns of care for elderly head-and-neck cancer patients with those of younger patients. Methods and Materials: A retrospective review was conducted of all new mucosal head-and-neck cancer referrals to radiation oncology between July 1, 2003 and December 31, 2007 at our institution. The clinical characteristics, treatment pattern, tolerance, and outcomes were compared between the elderly (aged {>=}75 years) and younger (aged <75 years) cohorts. Results: A total of 2,312 patients, including 452 (20%) elderly and 1,860 (80%) younger patients, were studied. The elderly patients were more likely to be women (36% vs. 27%, p <.01) and to have other malignancies (23% vs. 13%, p <.01), Stage I or II disease (38% vs. 32%, p <.01), and N0 status (56% vs. 42%, p <.01). Treatment was less often curative in intent (79% vs. 93%, p <.01). For the 1,487 patients who received definitive radiotherapy (RT), no differences were found between the elderly (n = 238) and younger (n = 1,249) patients in treatment interruption, completion, or treatment-related death. Within the subset of 760 patients who received intensified treatment (concurrent chemoradiotherapy or hyperfractionated accelerated RT), no difference was seen between the elderly (n = 46) and younger (nmore » = 714) patients in treatment interruption, completion, or treatment-related death. After a median follow-up of 2.5 years, the 2-year cause-specific survival rate after definitive RT was 72% (range, 65-78%) for the elderly vs. 86% (range, 84-88%) for the younger patients (p <.01). Conclusion: Elderly head-and-neck cancer patients exhibited different clinical characteristics and experienced different patterns of care from younger patients. Although age itself was an adverse predictor of cause-specific survival, its effect was modest. Elderly patients selected for definitive RT or intensified RT showed no evidence of impaired treatment tolerance.« less

Authors:
 [1]; ;  [1];  [2]; ;  [1];  [1]; ; ;  [1];  [3];  [4];  [1]
  1. Radiation Medicine Program, Princess Margaret Hospital, Toronto, ON (Canada)
  2. Department of Biostatistics, Princess Margaret Hospital, Toronto, ON (Canada)
  3. Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON (Canada)
  4. Division of Medical Oncology, Princess Margaret Hospital, Toronto, ON (Canada)
Publication Date:
OSTI Identifier:
21491535
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 79; Journal Issue: 1; Other Information: DOI: 10.1016/j.ijrobp.2009.10.052; PII: S0360-3016(09)03528-7; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ELDERLY PEOPLE; HEAD; NECK; NEOPLASMS; RADIOTHERAPY; ADULTS; AGE GROUPS; AGED ADULTS; ANIMALS; BODY; DISEASES; HUMAN POPULATIONS; MAMMALS; MAN; MEDICINE; MINORITY GROUPS; NUCLEAR MEDICINE; POPULATIONS; PRIMATES; RADIOLOGY; THERAPY; VERTEBRATES

Citation Formats

Shaohui, Huang, Department of Radiation Oncology, University of Toronto, Toronto, ON, O'Sullivan, Brian, Waldron, John, Department of Radiation Oncology, University of Toronto, Toronto, ON, Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Lockwood, Gina, Bayley, Andrew, Kim, John, Department of Radiation Oncology, University of Toronto, Toronto, ON, Cummings, Bernard, Department of Radiation Oncology, University of Toronto, Toronto, ON, Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Dawson, Laura A, Hope, Andrew, Cho, John, Department of Radiation Oncology, University of Toronto, Toronto, ON, Witterick, Ian, Department of Surgical Oncology, Princess Margaret Hospital, Toronto, ON, Chen, Eric X, Ringash, Jolie, and Department of Radiation Oncology, University of Toronto, Toronto, ON. Patterns of Care in Elderly Head-and-Neck Cancer Radiation Oncology Patients: A Single-Center Cohort Study. United States: N. p., 2011. Web. doi:10.1016/j.ijrobp.2009.10.052.
Shaohui, Huang, Department of Radiation Oncology, University of Toronto, Toronto, ON, O'Sullivan, Brian, Waldron, John, Department of Radiation Oncology, University of Toronto, Toronto, ON, Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Lockwood, Gina, Bayley, Andrew, Kim, John, Department of Radiation Oncology, University of Toronto, Toronto, ON, Cummings, Bernard, Department of Radiation Oncology, University of Toronto, Toronto, ON, Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Dawson, Laura A, Hope, Andrew, Cho, John, Department of Radiation Oncology, University of Toronto, Toronto, ON, Witterick, Ian, Department of Surgical Oncology, Princess Margaret Hospital, Toronto, ON, Chen, Eric X, Ringash, Jolie, & Department of Radiation Oncology, University of Toronto, Toronto, ON. Patterns of Care in Elderly Head-and-Neck Cancer Radiation Oncology Patients: A Single-Center Cohort Study. United States. https://doi.org/10.1016/j.ijrobp.2009.10.052
Shaohui, Huang, Department of Radiation Oncology, University of Toronto, Toronto, ON, O'Sullivan, Brian, Waldron, John, Department of Radiation Oncology, University of Toronto, Toronto, ON, Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Lockwood, Gina, Bayley, Andrew, Kim, John, Department of Radiation Oncology, University of Toronto, Toronto, ON, Cummings, Bernard, Department of Radiation Oncology, University of Toronto, Toronto, ON, Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Dawson, Laura A, Hope, Andrew, Cho, John, Department of Radiation Oncology, University of Toronto, Toronto, ON, Witterick, Ian, Department of Surgical Oncology, Princess Margaret Hospital, Toronto, ON, Chen, Eric X, Ringash, Jolie, and Department of Radiation Oncology, University of Toronto, Toronto, ON. 2011. "Patterns of Care in Elderly Head-and-Neck Cancer Radiation Oncology Patients: A Single-Center Cohort Study". United States. https://doi.org/10.1016/j.ijrobp.2009.10.052.
@article{osti_21491535,
title = {Patterns of Care in Elderly Head-and-Neck Cancer Radiation Oncology Patients: A Single-Center Cohort Study},
author = {Shaohui, Huang and Department of Radiation Oncology, University of Toronto, Toronto, ON and O'Sullivan, Brian and Waldron, John and Department of Radiation Oncology, University of Toronto, Toronto, ON and Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON and Lockwood, Gina and Bayley, Andrew and Kim, John and Department of Radiation Oncology, University of Toronto, Toronto, ON and Cummings, Bernard and Department of Radiation Oncology, University of Toronto, Toronto, ON and Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON and Dawson, Laura A and Hope, Andrew and Cho, John and Department of Radiation Oncology, University of Toronto, Toronto, ON and Witterick, Ian and Department of Surgical Oncology, Princess Margaret Hospital, Toronto, ON and Chen, Eric X and Ringash, Jolie and Department of Radiation Oncology, University of Toronto, Toronto, ON},
abstractNote = {Purpose: To compare the patterns of care for elderly head-and-neck cancer patients with those of younger patients. Methods and Materials: A retrospective review was conducted of all new mucosal head-and-neck cancer referrals to radiation oncology between July 1, 2003 and December 31, 2007 at our institution. The clinical characteristics, treatment pattern, tolerance, and outcomes were compared between the elderly (aged {>=}75 years) and younger (aged <75 years) cohorts. Results: A total of 2,312 patients, including 452 (20%) elderly and 1,860 (80%) younger patients, were studied. The elderly patients were more likely to be women (36% vs. 27%, p <.01) and to have other malignancies (23% vs. 13%, p <.01), Stage I or II disease (38% vs. 32%, p <.01), and N0 status (56% vs. 42%, p <.01). Treatment was less often curative in intent (79% vs. 93%, p <.01). For the 1,487 patients who received definitive radiotherapy (RT), no differences were found between the elderly (n = 238) and younger (n = 1,249) patients in treatment interruption, completion, or treatment-related death. Within the subset of 760 patients who received intensified treatment (concurrent chemoradiotherapy or hyperfractionated accelerated RT), no difference was seen between the elderly (n = 46) and younger (n = 714) patients in treatment interruption, completion, or treatment-related death. After a median follow-up of 2.5 years, the 2-year cause-specific survival rate after definitive RT was 72% (range, 65-78%) for the elderly vs. 86% (range, 84-88%) for the younger patients (p <.01). Conclusion: Elderly head-and-neck cancer patients exhibited different clinical characteristics and experienced different patterns of care from younger patients. Although age itself was an adverse predictor of cause-specific survival, its effect was modest. Elderly patients selected for definitive RT or intensified RT showed no evidence of impaired treatment tolerance.},
doi = {10.1016/j.ijrobp.2009.10.052},
url = {https://www.osti.gov/biblio/21491535}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 1,
volume = 79,
place = {United States},
year = {Sat Jan 01 00:00:00 EST 2011},
month = {Sat Jan 01 00:00:00 EST 2011}
}