Treatment Outcomes and the Safety of Chemoradiotherapy With High-Dose CDDP for Elderly Patients With Head and Neck Squamous Cell Carcinoma: A Propensity Score Matching Study

Objective: We aimed to compare the outcomes and safety of chemoradiotherapy (CRT) between elderly and non-elderly patients with head and neck squamous cell carcinoma (HNSCC). It is difficult to assess the causal effect of age because of possible differences in general conditions among individuals. T...

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Autores principales:	Jo Omata, Yushi Ueki, Takeshi Takahashi, Ryusuke Shodo, Keisuke Yamazaki, Kohei Saijo, Hisayuki Ota, Takafumi Togashi, Yuichiro Sato, Arata Horii
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	elderly patients chemoradiotherapy propensity score matching head and neck squamous cell carcinoma high-dose single-agent cisplatin Surgery RD1-811
Acceso en línea:	https://doaj.org/article/59e069f2818b4775b888d6440c6677c7
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spelling	oai:doaj.org-article:59e069f2818b4775b888d6440c6677c72021-11-30T11:48:18ZTreatment Outcomes and the Safety of Chemoradiotherapy With High-Dose CDDP for Elderly Patients With Head and Neck Squamous Cell Carcinoma: A Propensity Score Matching Study2296-875X10.3389/fsurg.2021.753049https://doaj.org/article/59e069f2818b4775b888d6440c6677c72021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fsurg.2021.753049/fullhttps://doaj.org/toc/2296-875XObjective: We aimed to compare the outcomes and safety of chemoradiotherapy (CRT) between elderly and non-elderly patients with head and neck squamous cell carcinoma (HNSCC). It is difficult to assess the causal effect of age because of possible differences in general conditions among individuals. Therefore, we adjusted the background factors of elderly and non-elderly patients using propensity score matching (PSM).Methods: A total of 146 patients with HNSCC who received CRT were divided into an elderly (≥70 years, n = 35) and non-elderly group (<70 years, n = 111). Pre-treatment characteristics, including the performance status, Charlson comorbidity index, body mass index, primary site, and TNM stage were adjusted by PSM. We compared the outcomes and safety of CRT with high-dose single-agent cisplatin (CDDP) as well as outcomes following recurrence between the groups, before and after PSM.Results: The total dose of CDDP administered during CRT was significantly lower in the elderly group before PSM. However, it became comparable to the non-elderly group and adverse events did not differ between the groups following PSM, resulting in a comparable CRT completion rate. Overall-, disease specific-, and progression-free survivals of elderly patients were comparable to those of non-elderly patients following PSM. In contrast, elderly patients with recurrence could receive fewer salvage treatments than their non-elderly counterparts, resulting in worse survival.Conclusions: CRT with high-dose CDDP is safe and effective for the treatment of elderly patients with HNSCC. However, salvage treatments can be rarely conducted for elderly patients with a recurrence, considering a deterioration of their general condition.Jo OmataYushi UekiTakeshi TakahashiRyusuke ShodoKeisuke YamazakiKohei SaijoHisayuki OtaTakafumi TogashiYuichiro SatoArata HoriiFrontiers Media S.A.articleelderly patientschemoradiotherapypropensity score matchinghead and neck squamous cell carcinomahigh-dose single-agent cisplatinSurgeryRD1-811ENFrontiers in Surgery, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	elderly patients chemoradiotherapy propensity score matching head and neck squamous cell carcinoma high-dose single-agent cisplatin Surgery RD1-811
spellingShingle	elderly patients chemoradiotherapy propensity score matching head and neck squamous cell carcinoma high-dose single-agent cisplatin Surgery RD1-811 Jo Omata Yushi Ueki Takeshi Takahashi Ryusuke Shodo Keisuke Yamazaki Kohei Saijo Hisayuki Ota Takafumi Togashi Yuichiro Sato Arata Horii Treatment Outcomes and the Safety of Chemoradiotherapy With High-Dose CDDP for Elderly Patients With Head and Neck Squamous Cell Carcinoma: A Propensity Score Matching Study
description	Objective: We aimed to compare the outcomes and safety of chemoradiotherapy (CRT) between elderly and non-elderly patients with head and neck squamous cell carcinoma (HNSCC). It is difficult to assess the causal effect of age because of possible differences in general conditions among individuals. Therefore, we adjusted the background factors of elderly and non-elderly patients using propensity score matching (PSM).Methods: A total of 146 patients with HNSCC who received CRT were divided into an elderly (≥70 years, n = 35) and non-elderly group (<70 years, n = 111). Pre-treatment characteristics, including the performance status, Charlson comorbidity index, body mass index, primary site, and TNM stage were adjusted by PSM. We compared the outcomes and safety of CRT with high-dose single-agent cisplatin (CDDP) as well as outcomes following recurrence between the groups, before and after PSM.Results: The total dose of CDDP administered during CRT was significantly lower in the elderly group before PSM. However, it became comparable to the non-elderly group and adverse events did not differ between the groups following PSM, resulting in a comparable CRT completion rate. Overall-, disease specific-, and progression-free survivals of elderly patients were comparable to those of non-elderly patients following PSM. In contrast, elderly patients with recurrence could receive fewer salvage treatments than their non-elderly counterparts, resulting in worse survival.Conclusions: CRT with high-dose CDDP is safe and effective for the treatment of elderly patients with HNSCC. However, salvage treatments can be rarely conducted for elderly patients with a recurrence, considering a deterioration of their general condition.
format	article
author	Jo Omata Yushi Ueki Takeshi Takahashi Ryusuke Shodo Keisuke Yamazaki Kohei Saijo Hisayuki Ota Takafumi Togashi Yuichiro Sato Arata Horii
author_facet	Jo Omata Yushi Ueki Takeshi Takahashi Ryusuke Shodo Keisuke Yamazaki Kohei Saijo Hisayuki Ota Takafumi Togashi Yuichiro Sato Arata Horii
author_sort	Jo Omata
title	Treatment Outcomes and the Safety of Chemoradiotherapy With High-Dose CDDP for Elderly Patients With Head and Neck Squamous Cell Carcinoma: A Propensity Score Matching Study
title_short	Treatment Outcomes and the Safety of Chemoradiotherapy With High-Dose CDDP for Elderly Patients With Head and Neck Squamous Cell Carcinoma: A Propensity Score Matching Study
title_full	Treatment Outcomes and the Safety of Chemoradiotherapy With High-Dose CDDP for Elderly Patients With Head and Neck Squamous Cell Carcinoma: A Propensity Score Matching Study
title_fullStr	Treatment Outcomes and the Safety of Chemoradiotherapy With High-Dose CDDP for Elderly Patients With Head and Neck Squamous Cell Carcinoma: A Propensity Score Matching Study
title_full_unstemmed	Treatment Outcomes and the Safety of Chemoradiotherapy With High-Dose CDDP for Elderly Patients With Head and Neck Squamous Cell Carcinoma: A Propensity Score Matching Study
title_sort	treatment outcomes and the safety of chemoradiotherapy with high-dose cddp for elderly patients with head and neck squamous cell carcinoma: a propensity score matching study
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/59e069f2818b4775b888d6440c6677c7
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Treatment Outcomes and the Safety of Chemoradiotherapy With High-Dose CDDP for Elderly Patients With Head and Neck Squamous Cell Carcinoma: A Propensity Score Matching Study

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