Clinical outcomes in elderly patients with human papillomavirus-positive squamous cell carcinoma of the oropharynx treated with definitive chemoradiation therapy

• Published in: Head & neck Vol. 38; no. 6; pp. 846 - 851
• Main Authors: Hanasoge, Sheela, Magliocca, Kelly R., Switchenko, Jeffrey M., Saba, Nabil F., Wadsworth, J. Trad, El-Deiry, Mark W., Shin, Dong M., Khuri, Fadlo, Beitler, Jonathan J., Higgins, Kristin A.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.06.2016; Wiley Subscription Services, Inc
• Subjects: Aged; Carcinoma, Squamous Cell - etiology; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - therapy; chemoradiation; Chemoradiotherapy - adverse effects; elderly; Female; Human papillomavirus; Human papillomavirus 16 - isolation & purification; human papillomavirus-positive (HPV+); Humans; Male; oropharyngeal cancer; Oropharyngeal Neoplasms - etiology; Oropharyngeal Neoplasms - mortality; Oropharyngeal Neoplasms - therapy; Papillomavirus Infections - complications; Retrospective Studies; Survival Analysis; Treatment Outcome; human papillomavirus-positive (HPV+); oropharyngeal cancer; chemoradiation; elderly
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.24073

Background The benefit of combined chemoradiation in elderly patients with human papillomavirus (HPV)‐positive locally advanced oropharyngeal squamous cell carcinoma (SCC) must be balanced with the potential for higher toxicity rates. We performed a retrospective review of our institutional experience. Methods Patients 70 years or older with p16‐positive oropharyngeal SCC treated with definitive chemoradiation from 2005 to 2013 were evaluated. Overall survival (OS), disease‐free survival (DFS), and locoregional failure–free survival were calculated. Results Twenty‐one eligible patients had a follow‐up of 22.4 months. Estimated 5‐year OS, DFS, and locoregional failure–free survival were 76.0%, 40%, and 95%, respectively. There was 1 death from acute toxicity, and 50% had unplanned hospitalizations. Sixty percent had late toxicity, and 6‐month feeding tube dependence was 25%. Conclusion Elderly patients with HPV‐positive locally advanced SCC of the oropharynx treated with definitive chemoradiation had good OS but high rates of acute and long‐term toxicity. © 2015 Wiley Periodicals, Inc. Head Neck 38: 846–851, 2015