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

Head Neck. 2016 Jun;38(6):846-51. doi: 10.1002/hed.24073. Epub 2015 Jul 30.

Abstract

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.

Keywords: chemoradiation; elderly; human papillomavirus-positive (HPV+); oropharyngeal cancer.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell / etiology
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / therapy*
  • Chemoradiotherapy / adverse effects*
  • Female
  • Human papillomavirus 16 / isolation & purification*
  • Humans
  • Male
  • Oropharyngeal Neoplasms / etiology
  • Oropharyngeal Neoplasms / mortality
  • Oropharyngeal Neoplasms / therapy*
  • Papillomavirus Infections / complications*
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome