Background: A wide percentage (25–40%) of patients affected by head and neck squamous cell carcinoma (HNSCC) are over 70 years old, and they present with different characteristics if compared to younger patients. Elderly patients often receive less intensive, non-surgical, and non-multimodal treatments. Although age does not mean frailty, the elderly are at a higher risk of developing toxicity. In fact, several studies enrolling patients treated with cisplatin + radiotherapy (CISPLATIN + RT) or cetuximab + radiotherapy (Cet + RT) showed reduced efficacy over 65 years. Methods: We conducted a multicenter retrospective analysis in patients with Locally Advanced HNSCC aged over 65 years, who underwent Cet-RT, diagnosed in the period between 2017 and 2024. The primary endpoint was to describe Overall Survival (OS), the secondary endpoints were Progression Free Survival (PFS) and the percentage and type of Adverse Events (AEs). Patients received a geriatric assessment using the G8 questionnaire. Results: Data regarding Eighty-Two (82) patients were analyzed, median age was 74 years (range 65–84), most patients had oral cavity (26.8%) and laryngeal cancer (37.8%). Fifty-six point one (56.1%) of patients were smokers, and 17.1% reported alcohol consumption. All patients completed radiotherapy, and 80.5% of them developed AEs, which in 25.6% of cases were G3–4 toxicities. No relationship was found between G3–4 AEs and age (p= 0.596), G8score < 14 (p= 0.804), and smoking (p= 0.245)/drinking habits (p= 0.341). Median OS was 58 months, with a slightly non-significant positive trend in OS for patients who were non-smokers and those who did not develop G3–4 AEs (p= 0.786 and 0.799, respectively). Association between folliculitis and OS was statistically significant (p= 0.001). Conclusions: In elderly patients, Cet-RT represents a feasible, well-tolerated option, although further prospective studies are needed.
背景：头颈部鳞状细胞癌（HNSCC）患者中，有相当大比例（25%-40%）年龄超过70岁，与年轻患者相比，他们呈现出不同的临床特征。老年患者通常接受强度较低、非手术及非多模式治疗。尽管年龄并不等同于衰弱，但老年患者发生治疗毒性的风险更高。事实上，多项针对接受顺铂联合放疗（CISPLATIN + RT）或西妥昔单抗联合放疗（Cet + RT）治疗患者的研究显示，65岁以上患者的疗效有所降低。 方法：我们对2017年至2024年间确诊、年龄超过65岁的局部晚期HNSCC患者进行了多中心回顾性分析，这些患者均接受了Cet-RT治疗。主要研究终点为总生存期（OS），次要终点包括无进展生存期（PFS）以及不良事件（AEs）的发生率和类型。所有患者均通过G8问卷进行了老年综合评估。 结果：共分析了82例患者数据，中位年龄74岁（范围65-84岁），最常见原发部位为口腔癌（26.8%）和喉癌（37.8%）。56.1%的患者有吸烟史，17.1%有饮酒史。所有患者均完成放疗，其中80.5%出现AEs，25.6%为G3-4级毒性。G3-4级AEs与年龄（p=0.596）、G8评分<14分（p=0.804）、吸烟（p=0.245）及饮酒习惯（p=0.341）均无显著相关性。中位OS为58个月，非吸烟者和未发生G3-4级AEs的患者OS呈轻微非显著性正向趋势（p值分别为0.786和0.799）。毛囊炎与OS的相关性具有统计学意义（p=0.001）。 结论：对于老年患者，Cet-RT是一种可行且耐受性良好的治疗选择，但仍需进一步前瞻性研究验证。
肿瘤(癌症)患者之家