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Outcome of radiotherapy for the treatment of laryngeal squamous cell carcinoma in the very elderly population

Published online by Cambridge University Press:  13 February 2023

Orly Yariv Open the ORCID record for Orly Yariv [Opens in a new window] ,
Nimrod Amitai ,
Yuval Nachalon ,
Assaf Moore  and
Aron Popovtzer
Orly Yariv*
Affiliation:
Institute of Oncology, Davidoff Cancer Center, Rabin Medical Center – Beilinson Hospital, Petach Tikva, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Nimrod Amitai
Affiliation:
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Department of Otorhinolaryngology – Head and Neck Surgery, Rabin Medical Center – Beilinson Hospital, Petach Tikva, Israel
Yuval Nachalon
Affiliation:
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Department of Otorhinolaryngology – Head and Neck Surgery, Rabin Medical Center – Beilinson Hospital, Petach Tikva, Israel
Assaf Moore
Affiliation:
Institute of Oncology, Davidoff Cancer Center, Rabin Medical Center – Beilinson Hospital, Petach Tikva, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Aron Popovtzer
Affiliation:
Institute of Oncology, Davidoff Cancer Center, Rabin Medical Center – Beilinson Hospital, Petach Tikva, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
*
Corresponding author: Orly Yariv; Email: yarivorly@gmail.com Fax: +972 3 937 8047
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Abstract

Background

Treatment selection for squamous cell carcinoma patients aged over 84 years is controversial. This retrospective chart review examined and compared characteristics of laryngeal squamous cell carcinoma in very elderly (over 84 years) and younger patients (approximately 65 years). The secondary objective was to further evaluate the outcome of radiotherapy as a treatment modality in this patient population.

Methods

Of all 23 very elderly patients with laryngeal squamous cell carcinoma treated with radiotherapy, with or without surgery, in the Davidoff Cancer Center, from 1992 to 2012, 19 had sufficient data for analysis, and comprised the study group.

Results

Median age at diagnosis was 86 years. Disease stage at diagnosis was I, II, III and IVA in 53 per cent, 21 per cent, 21 per cent and 5 per cent, respectively. Median radiotherapy dose was 60 Gy given in 25 fractions. Three patients had recurrence. No patient discontinued treatment because of toxicity. Median overall survival was 3.6 years (range, 0–10 years).

Conclusion

Very elderly laryngeal squamous cell carcinoma patients may derive a similar survival advantage as younger counterparts. Modern radiotherapy is effective and safe for treating laryngeal squamous cell carcinoma in this study population. Further, large-scale studies are needed.

Keywords

Laryngeal cancerradiationelderly patientsglottissquamous cell carcinoma

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 138 , Issue 4 , April 2024 , pp. 443 - 447
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

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Footnotes

Orly Yariv takes responsibility for the integrity of the content of the paper

References

Siegel, RL, Miller, KD, Jemal, A. Cancer statistics, 2017. CA Cancer J Clin 2017;67:7–30CrossRefGoogle ScholarPubMed
Balducci, L. Management of cancer in the elderly. Oncology (Williston Park) 2006;20:135–43Google ScholarPubMed
Barzan, L, Veronesi, A, Caruso, G, Serraino, D, Magri, D, Zagonel, V et al. Head and neck cancer and aging: a retrospective study in 438 patients. J Laryngol Otol 1990;104:634–40CrossRefGoogle ScholarPubMed
Sarini, J, Fournier, C, Lefebvre, JL, Bonafos, G, Van, JT, Coche-Dequéant, B. Head and neck squamous cell carcinoma in elderly patients. Arch Otolaryngol Head Neck Surg 2001;127:1089–92CrossRefGoogle ScholarPubMed
Vaccher, E, Talamini, R, Franchin, G, Tirelli, U, Barzan, L. Elderly head and neck (H–N) cancer patients: a monoinstitutional series. Tumori 2002;88:63–6CrossRefGoogle ScholarPubMed
Derks, W, de Leeuw, JR, Hordijk, GJ, Winnubst, JA. Reasons for non-standard treatment in elderly patients with advanced head and neck cancer. Eur Arch Otorhinolaryngol 2005;262:21–6CrossRefGoogle ScholarPubMed
Huang, SH, O'Sullivan, B, Waldron, J, Lockwood, G, Bayley, A, Kim, J et al. Patterns of care in elderly head and neck cancer radiation oncology patients: a single-center cohort study. Int J Radiat Oncol Biol Phys 2011;79:46–51CrossRefGoogle ScholarPubMed
Lewis, JH, Kilgore, ML, Goldman, DP, Trimble, EL, Kaplan, R, Montello, MJ et al. Participation of patients 65 years of age or older in cancer clinical trials. J Clin Oncol 2003;21:1383–9CrossRefGoogle ScholarPubMed
Murthy, VH, Krumholz, HM, Gross, CP. Participation in cancer clinical trials: race-, sex-, and age-based disparities. JAMA 2004;291:2720–6CrossRefGoogle ScholarPubMed
Muss, HB. Cancer in the elderly: a societal perspective from the United States. Clin Oncol (R Coll Radiol) 2009;21:92–8CrossRefGoogle ScholarPubMed
Amin, MB, Edge, SB, Greene, FL, Compton, CC, Gershenwald, JE, Brookland, RK et al. AJCC Cancer Staging Manual, 8th edn. New York: Springer, 2017Google ScholarPubMed
National Cancer Institute. Surveillance, Epidemiology, and End Results Program, 2018. In: https://seer.cancer.gov/data-software/ [6 June 2018]Google Scholar
Argiris, A, Eng, C. Epidemiology, staging, and screening of head and neck cancer. Cancer Treat Res 2003;114:15–60CrossRefGoogle ScholarPubMed
de Rijke, JM, Schouten, LJ, Schouten, HC, Jager, JJ, Kopperjan, AG, van den Brandt, PA. Age-specific differences in the diagnostics and treatment of cancer patients aged 50 years and older in the province of Limburg, The Netherlands. Ann Oncol 1996;7:677–85CrossRefGoogle ScholarPubMed
Fentiman, IS, Tirelli, U, Monfardini, S, Schneider, M, Festen, J, Cognetti, F et al. Cancer in the elderly: why so badly treated? Lancet 1990;335:1020–2CrossRefGoogle Scholar
Pignon, T, Horiot, JC, Van den Bogaert, W, Van Glabbeke, M, Scalliet, P. No age limit for radical radiotherapy in head and neck tumours. Eur J Cancer 1996;32A:2075–81CrossRefGoogle ScholarPubMed
Ang, KK, Harris, J, Wheeler, R, Weber, R, Rosenthal, DI, Nguyen-Tân, PF et al. Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med 2010;363:24–35CrossRefGoogle ScholarPubMed
Koch, WM, Patel, H, Brennan, J, Boyle, JO, Sidransky, D. Squamous cell carcinoma of the head and neck in the elderly. Arch Otolaryngol Head Neck Surg 1995;121:262–5CrossRefGoogle ScholarPubMed
Jones, PA. DNA methylation errors and cancer. Cancer Res 1996;56:2463–7Google ScholarPubMed
Mell, LK, Dignam, JJ, Salama, JK, Cohen, EE, Polite, BN, Dandekar, V et al. Predictors of competing mortality in advanced head and neck cancer. J Clin Oncol 2010;28:15–20CrossRefGoogle ScholarPubMed
Ildstad, ST, Tollerud, DJ, Bigelow, ME, Remensnyder, JP. A multivariate analysis of determinants of survival for patients with squamous cell carcinoma of the head and neck. Ann Surg 1989;209:237–41CrossRefGoogle ScholarPubMed
Olmi, P, Ausili-Cefaro, G. Radiotherapy in the elderly: a multicentric prospective study on 2060 patients referred to 37 Italian radiation therapy centers. Rays 1997;22(1 suppl):53–6Google ScholarPubMed
Sesterhenn, AM, Teymoortash, A, Folz, BJ, Werner, JA. Head and neck cancer in the elderly: a cohort study in 40 patients. Acta Oncol 2005;44:59–64CrossRefGoogle ScholarPubMed
Syrigos, KN, Karachalios, D, Karapanagiotou, EM, Nutting, CM, Manolopoulos, L, Harrington, KJ. Head and neck cancer in the elderly: an overview on the treatment modalities. Cancer Treat Rev 2009;35:237–45CrossRefGoogle ScholarPubMed
Bernardi, D, Barzan, L, Franchin, G, Cinelli, R, Balestreri, L, Tirelli, U et al. Treatment of head and neck cancer in elderly patients: state of the art and guidelines. Crit Rev Oncol Hematol 2005;53:71–80CrossRefGoogle ScholarPubMed
Bhattacharyya, N. A matched survival analysis for squamous cell carcinoma of the head and neck in the elderly. Laryngoscope 2003;113:368–72CrossRefGoogle ScholarPubMed
Clayman, GL, Eicher, SA, Sicard, MW, Razmpa, E, Goepfert, H. Surgical outcomes in head and neck cancer patients 80 years of age and older. Head Neck 1998;20:216–233.0.CO;2-3>CrossRefGoogle ScholarPubMed
Horiot, JC. Radiation therapy and the geriatric oncology patient. J Clin Oncol 2007;25:1930–5CrossRefGoogle ScholarPubMed
Italiano, A, Ortholan, C, Dassonville, O, Poissonnet, G, Thariat, J, Benezery, K et al. Head and neck squamous cell carcinoma in patients aged > or = 80 years: patterns of care and survival. Cancer 2008;113:3160–8CrossRefGoogle ScholarPubMed
Olmi, P, Ausili-Cefaro, G, Loreggian, L. Radiation therapy in the elderly with head and neck cancer. Rays 1997;22(1 suppl):77–81Google ScholarPubMed
Maggiore, RJ, Curran, EK, Witt, ME, Haraf, DJ, Vokes, EE, Cohen, EE. Survival and selected outcomes of older adults with locally advanced head/neck cancer treated with chemoradiation therapy. J Geriatr Oncol 2013;4:327–33CrossRefGoogle ScholarPubMed
Ortholan, C, Lusinchi, A, Italiano, A, Bensadoun, RJ, Auperin, A, Poissonnet, G et al. Oral cavity squamous cell carcinoma in 260 patients aged 80 years or more. Radiother Oncol 2009;93:516–23CrossRefGoogle ScholarPubMed
Metges, JP, Eschwege, F, de Crevoisier, R, Lusinchi, A, Bourhis, J, Wibault, P. Radiotherapy in head and neck cancer in the elderly: a challenge. Crit Rev Oncol Hematol 2000;34:195–203CrossRefGoogle ScholarPubMed
Schofield, CP, Sykes, AJ, Slevin, NJ, Rashid, NZ. Radiotherapy for head and neck cancer in elderly patients. Radiother Oncol 2003;69:37–42CrossRefGoogle ScholarPubMed
Zachariah, B, Balducci, L, Venkattaramanabalaji, GV, Casey, L, Greenberg, HM, DelRegato, JA. Radiotherapy for cancer patients aged 80 and older: a study of effectiveness and side effects. Int J Radiat Oncol Biol Phys 1997;39:1125–9CrossRefGoogle Scholar
Oguchi, M, Ikeda, H, Watanabe, T, Shikama, N, Ohata, T, Okazaki, Y et al. Experience of 23 patients > or = 90 years of age treated with radiation therapy. Int J Radiat Oncol Biol Phys 1998;41:407–13CrossRefGoogle ScholarPubMed
Mitsuhashi, N, Hayakawa, K, Sakurai, H, Sakurai, H, Saito, Y, Hasegawa, M et al. Cancer in patients aged 90 years or older: radiation therapy. Radiology 1999;211:829–33CrossRefGoogle ScholarPubMed
Wasil, T, Lichtman, SM, Gupta, V, Rush, S. Radiation therapy in cancer patients 80 years of age and older. Am J Clin Oncol 2000;23:526–30CrossRefGoogle ScholarPubMed
Yamakawa, M, Shiojima, K, Takahashi, M, Saito, Y, Matsumoto, H, Mitsuhashi, N et al. Radiation therapy for esophageal cancer in patients over 80 years old. Int J Radiat Oncol Biol Phys 1994;30:1225–32CrossRefGoogle ScholarPubMed
Hishikawa, Y, Kurisu, K, Taniguchi, M, Kamikonya, N, Miura, T. Radiotherapy for carcinoma of the esophagus in patients aged eighty or older. Int J Radiat Oncol Biol Phys 1991;20:685–8CrossRefGoogle ScholarPubMed
Geinitz, H, Zimmermann, FB, Molls, M. Radiotherapy of the elderly patient. Radiotherapy tolerance and results in older patients [in German]. Strahlenther Onkol 1999;175:119–27CrossRefGoogle ScholarPubMed
Feng, Y, Wang, B, Wen, S. Laser surgery versus radiotherapy for T1–T2No glottic cancer: a meta-analysis. ORL J Otorhinolaryngol Relat Spec 2011;73:336–42CrossRefGoogle Scholar
Gugić, J, Strojan, P. Squamous cell carcinoma of the head and neck in the elderly. Rep Pract Oncol Radiother 2013;18:16–25CrossRefGoogle Scholar
Mountzios, G. Optimal management of the elderly patient with head and neck cancer: issues regarding surgery, irradiation and chemotherapy. World J Clin Oncol 2015;6:7–15CrossRefGoogle ScholarPubMed
Tsukuda, M, Ishitoya, J, Mikami, Y, Matsuda, H, Horiuchi, C, Taguchi, T et al. Analysis of feasibility and toxicity of concurrent chemoradiotherapy with S-1 for locally advanced squamous cell carcinoma of the head and neck in elderly cases and/or cases with comorbidity. Cancer Chemother Pharmacol 2009;64:945–52CrossRefGoogle ScholarPubMed
Airoldi, M, Cortesina, G, Giordano, C, Pedani, F, Gabriele, AM, Marchionatti, S et al. Postoperative adjuvant chemoradiotherapy in older patients with head and neck cancer. Arch Otolaryngol Head Neck Surg 2004;130:161–6CrossRefGoogle ScholarPubMed
Michal, SA, Adelstein, DJ, Rybicki, LA, Rodriguez, CP, Saxton, JP, Wood, BG et al. Multi-agent concurrent chemoradiotherapy for locally advanced head and neck squamous cell cancer in the elderly. Head Neck 2012;34:1147–52CrossRefGoogle ScholarPubMed
Merlano, MC, Monteverde, M, Colantonio, I, Denaro, N, Lo Nigro, C, Natoli, G et al. Impact of age on acute toxicity induced by bio- or chemo-radiotherapy in patients with head and neck cancer. Oral Oncol 2012;48:1051–7CrossRefGoogle ScholarPubMed