Background: With aging populations, the incidence of squamous cell carcinoma of the head and neck (SCCHN) among elderly patients is increasing. Although adjuvant radiotherapy or chemoradiation is a well-established component of multimodal treatment, elderly patients remain underrepresented in clinical trials. This study evaluates the feasibility of adjuvant radiotherapy and chemoradiation in patients over 70 years with SCCHN and explores the correlation between treatment feasibility and various comorbidity scores.Methods: We retrospectively analyzed patients over 70 years of age who received adjuvant radiotherapy or chemoradiation at the University Hospital Regensburg between 2004 and 2018. A total of 71 patients, with a median age of 75 years, were included. The majority were classified as UICC stage IVa. Median follow-up was 27 months.Results: Sixty-two patients completed treatment without interruption, and sixty-five received at least 95% of the prescribed radiation dose. The median total dose was 64 Gy. Acute toxicity of grade III or IV (CTC) occurred in 37 patients. Local tumor control rates were 99% at 12 months, 88% at 24 months, and 76% at 5 years. Overall survival rates were 87% at 12 months, 67% at 24 months, and 41% at 60 months, with a median overall survival of 51 months. The Elixhauser Comorbidity Score showed significant predictive value for treatment feasibility (p= 0.006).Conclusions: Adjuvant radiotherapy and chemoradiation are feasible and effective treatment options for elderly patients with SCCHN. The favorable local and locoregional control rates reported here suggest, in line with other recent reports in the literature, that age alone should not be a justification for treatment de-intensification.
背景：随着人口老龄化，老年患者头颈部鳞状细胞癌（SCCHN）的发病率日益上升。尽管辅助放疗或放化疗是多模式治疗中公认的重要组成部分，但老年患者在临床试验中的代表性仍然不足。本研究评估了70岁以上SCCHN患者接受辅助放疗及放化疗的可行性，并探讨治疗可行性与多种合并症评分之间的相关性。 方法：我们回顾性分析了2004年至2018年间在雷根斯堡大学医院接受辅助放疗或放化疗的70岁以上患者。共纳入71例患者，中位年龄75岁，其中大多数患者为UICC IVa期。中位随访时间为27个月。 结果：62例患者顺利完成治疗未中断，65例患者接受了至少95%的处方放射剂量。中位总剂量为64 Gy。37例患者出现III级或IV级（CTC标准）急性毒性反应。局部肿瘤控制率在12个月时为99%，24个月时为88%，5年时为76%。总生存率在12个月时为87%，24个月时为67%，60个月时为41%，中位总生存期为51个月。Elixhauser合并症评分对治疗可行性具有显著预测价值（p=0.006）。 结论：辅助放疗和放化疗是老年SCCHN患者可行且有效的治疗选择。本研究报道的良好局部及区域控制率表明，正如近期其他文献报告所指出的，年龄本身不应成为降低治疗强度的理由。
肿瘤(癌症)患者之家