Feasibility of Adjuvant Radiotherapy or Chemoradiation for Elderly Patients with Squamous Cell Carcinoma of the Head and Neck, and Its Correlation with Different Comorbidity Scores: A Retrospective Cohort Study

Suess, Christoph and Hipp, Matthias and Ettl, Tobias and Kuenzel, Julian and Maurer, Julia and Ratzisberger, Anna and Baier, Fabian and Steger, Felix and Koelbl, Oliver and Hautmann, Matthias (2025) Feasibility of Adjuvant Radiotherapy or Chemoradiation for Elderly Patients with Squamous Cell Carcinoma of the Head and Neck, and Its Correlation with Different Comorbidity Scores: A Retrospective Cohort Study. CANCERS, 17 (14): 2283. ISSN , 2072-6694

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Abstract

Background: With aging populations, the incidence of squamous cell carcinoma of the head and neck (SCCHN) among elderly patients is increasing. Although adjuvant radiotherapy or chemoradiation is a well-established component of multimodal treatment, elderly patients remain underrepresented in clinical trials. This study evaluates the feasibility of adjuvant radiotherapy and chemoradiation in patients over 70 years with SCCHN and explores the correlation between treatment feasibility and various comorbidity scores. Methods: We retrospectively analyzed patients over 70 years of age who received adjuvant radiotherapy or chemoradiation at the University Hospital Regensburg between 2004 and 2018. A total of 71 patients, with a median age of 75 years, were included. The majority were classified as UICC stage IVa. Median follow-up was 27 months. Results: Sixty-two patients completed treatment without interruption, and sixty-five received at least 95% of the prescribed radiation dose. The median total dose was 64 Gy. Acute toxicity of grade III or IV (CTC) occurred in 37 patients. Local tumor control rates were 99% at 12 months, 88% at 24 months, and 76% at 5 years. Overall survival rates were 87% at 12 months, 67% at 24 months, and 41% at 60 months, with a median overall survival of 51 months. The Elixhauser Comorbidity Score showed significant predictive value for treatment feasibility (p = 0.006). Conclusions: Adjuvant radiotherapy and chemoradiation are feasible and effective treatment options for elderly patients with SCCHN. The favorable local and locoregional control rates reported here suggest, in line with other recent reports in the literature, that age alone should not be a justification for treatment de-intensification.

Item Type: Article
Uncontrolled Keywords: LOCALLY ADVANCED HEAD; INTERNATIONAL-SOCIETY; OLDER PATIENTS; CANCER; CHEMOTHERAPY; ONCOLOGY; INDEX; IDENTIFICATION; EPIDEMIOLOGY; ASPIRATION; head and neck cancer; SCCHN; elderly patients; frail patients; radiotherapy; comorbidity score
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Hals-Nasen-Ohren-Heilkunde
Medicine > Lehrstuhl für Mund-, Kiefer- und Gesichtschirurgie
Medicine > Lehrstuhl für Strahlentherapie
Depositing User: Dr. Gernot Deinzer
Date Deposited: 28 Jul 2026 08:56
Last Modified: 28 Jul 2026 08:56
URI: https://pred.uni-regensburg.de/id/eprint/66119

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