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Radiotherapy with or without chemotherapy for locally advanced head and neck cancer in elderly patients: analysis of the Head and Neck Cancer Registry of Japan

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Abstract

Background

Whether concurrent chemotherapy with radiotherapy (CRT) is effective for elderly patients with head and neck cancer is a controversial topic. This study aimed to analyze the effectiveness of CRT vs. radiation therapy (RT) among elderly patients in Japan.

Methods

Data from the Head and Neck Cancer Registry of Japan were extracted and analyzed. Patients with locally advanced squamous cell carcinoma of the oropharynx, hypopharynx, or larynx who received definitive CRT or RT between 2011 and 2014 were included.

Results

CRT was administered to 78% of the 1057 patients aged ≥ 70 years and 67% of the 555 patients aged ≥ 75 years. For the patients aged ≥ 75 years, the overall survival (OS) rate was significantly better in the CRT group than in the RT group (P < 0.05), while the progression-free survival (PFS) rate was not significantly different (P > 0.05). The add-on effect of CRT was significantly poor in elderly patients (P < 0.05), and it was not a significant factor in the multivariate analysis for patients aged ≥ 75 years. After propensity score matching, there were no significant differences in the OS and PFS rates between the patients aged ≥ 70 years and those aged ≥ 75 years (all, P > 0.05).

Conclusion

Although aggressive CRT is administered to elderly patients in Japan, its effectiveness is uncertain. Further prospective randomized trials are needed to verify whether CRT is superior to RT alone for elderly patients.

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Data availability

The data generated in this study are available in the article.

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Acknowledgements

We express our deepest gratitude to the members of the Japanese Society for Head and Neck Cancer who participated in the Head and Neck Cancer Registry of Japan and to the members of the Cancer Registry Committee.

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Authors and Affiliations

  1. Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, North-15 West-7, Sapporo, 060-8638, Japan

    Koichi Yasuda, Yusuke Uchinami, Kentaro Nishioka, Takashi Mori, Fuki Koizumi, Yuri Fujii & Hidefumi Aoyama

  2. Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan

    Satoshi Kano & Akihiro Homma

  3. Department of Medical Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan

    Jun Taguchi & Yasushi Shimizu

  4. Japan Society for Head and Neck Cancer, Tokyo, Japan

    Daisuke Kawakita, Megumi Kitayama, Seiichi Yoshimoto & Ken-ichi Nibu

  5. Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan

    Daisuke Kawakita

  6. Clinical Study Support Center, Wakayama Medical University Hospital, Wakayama, Japan

    Megumi Kitayama

  7. Global Center for Biomedical Science and Engineering, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Sapporo, Japan

    Kentaro Nishioka, Keiji Kobashi & Hidefumi Aoyama

  8. Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan

    Seiichi Yoshimoto

  9. Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan

    Ken-ichi Nibu

Authors
  1. Koichi Yasuda
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  2. Yusuke Uchinami
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  3. Satoshi Kano
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  4. Jun Taguchi
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  6. Megumi Kitayama
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  7. Kentaro Nishioka
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  8. Takashi Mori
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  9. Fuki Koizumi
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  10. Yuri Fujii
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  12. Keiji Kobashi
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  13. Seiichi Yoshimoto
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  15. Akihiro Homma
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  16. Hidefumi Aoyama
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Contributions

KY: conceptualization and design; development of the methodology; acquisition and analysis of the data; and writing, review, and revision of the article. YU: development of the methodology and review and revision of the article. SK: review and revision of the article. JT: review and revision of the article. DK: ethics review; acquisition and processing of data; and review of the article. MK: acquisition of data and review of the article. KN: review and revision of the article. TM: review and revision of the article. FK: analysis of the data and review and revision of the article. YF: analysis of the data and review and revision of the article. YS: review and revision of the article. KK: review and revision of the article. SY: ethics review; and review of the article. KN: ethics review and review of the article. AH: review and revision of the article. HA: review and revision of the article; and funding acquisition.

Corresponding author

Correspondence to Koichi Yasuda.

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Conflict of interest

KK is an employee of an institute of Hitachi Ltd. and currently works for Hokkaido University under a secondary agreement, but KK declares that this research has no relationship with Hitachi Ltd.

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Yasuda, K., Uchinami, Y., Kano, S. et al. Radiotherapy with or without chemotherapy for locally advanced head and neck cancer in elderly patients: analysis of the Head and Neck Cancer Registry of Japan. Int J Clin Oncol 29, 241–247 (2024). https://doi.org/10.1007/s10147-023-02450-7

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  • DOI: https://doi.org/10.1007/s10147-023-02450-7

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