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Radiotherapy for Older Adults With Cutaneous Squamous Cell Carcinoma of the Head/Neck

By: Jenna Carter, PhD
Posted: Thursday, February 1, 2024

The standard curative treatment of cutaneous squamous cell carcinoma of the head and neck includes radical surgery followed by adjuvant radiotherapy. Because this treatment is not well tolerated in most patients aged 75 and older, Francesca De Felice, PhD, of Sapienza University of Rome, and colleagues examined the role of definitive weekly hypofractionated radiotherapy in the older adult population. Their findings, which were published in the Journal of Geriatric Oncology, demonstrated an objective response rate of 92.6%, with a duration of response at a median of 12 months.

“Cutaneous squamous cell carcinoma of the head and neck region…predominantly affects patients older than 65 years. The standard curative treatment approach…oftentimes cannot be feasibly applied to older adult patients (≥ 75 years), mainly due to their sometimes suboptimal functional status or comorbidities,” stated Dr. De Felice and colleagues.

A total of 19 older adults with cutaneous squamous cell carcinoma of the head and neck region were included in this study. Patients received definitive weekly hypofractionated radiotherapy using megavoltage electrons. After radiotherapy, patients were examined monthly; however, in the case of a complete response, evaluations were performed every 3 months for 2 years and every 6 months for up to 5 years. The primary endpoint was an objective response rate at 3 months after radiotherapy, and secondary endpoints included (but were not limited to) duration of response, progression-free survival, and overall survival.

Findings revealed 1- and 2-year progression-free survival rates of 63.0% (95% confidence interval [CI] = 35.2%–81.8%) and 52.7% (95% CI = 23.6%–75.2%), respectively. The 1- and 2-year overall survival rates were 74.2% (95% CI = 44.8%–89.5%) and 56.2% (95% CI = 25.3%–78.5%), respectively. Additionally, all patients received the total dose without interruptions in treatment, and there were no cases of severe toxicity reported.

Disclosure: The study authors reported no conflicts of interest.

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