Despite conflicting prospective evidence, most elderly patients with locoregionally advanced head and neck cancer treated with definitive radiotherapy also receive systemic therapy, according to results from a study published in Cancer.
Systemic therapies are those that spread throughout the body to treat cancer cells residing in different regions of the body. For this reason, it is a treatment tactic often used in patients with metastatic disease to help manage symptoms and control disease growth.
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The study, led by Matthew C Ward, MD, Cleveland Clinic, OH, looked at elderly patients aged 70 years or older who received radiotherapy with or without systemic therapy for stage III to IVB squamous cell carcinoma of the nasopharynx, oropharynx, larynx, or hypopharynx between 2004 and 2012. Researchers measured the association between systemic therapy use and overall survival using a multivariate, inverse probability-weighted propensity score-adjusted Cox proportional hazards model.
A total of 4165 eligible patients were identified using the National Cancer Data Base, 80.4% of whom received systemic therapy. Median follow-up was 26 months and the rate of 3-year overall survival was 51.6%. During the study period, researchers observed that the frequency of systemic therapy use grew from 64% in 2004 to 86% in 2012. Additionally, those who were treated with systemic therapy experienced improved overall survival in the multivariate model. However, an age threshold above which the improvement in overall survival ceased was not identified.
Thus, researchers concluded that, in contrast to available evidence, the majority of elderly patients with locoregionally advanced head and neck cancer treated with definitive radiotherapy also receive systemic therapy. Further, the survival benefits associated with systemic therapy use suggest that is should be a patient-specific decision in all age groups.
