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dc.contributor.authorVerma, V.
dc.contributor.authorSurkar, S.M.
dc.contributor.authorMoreno, A.C.
dc.date.accessioned2019-05-17T13:21:14Z
dc.date.available2019-05-17T13:21:14Z
dc.date.issued2018
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85044672648&doi=10.1002%2fcam4.1290&partnerID=40&md5=7247d7dc9bc4673ae837854bcb85f1d0
dc.identifier.urihttp://hdl.handle.net/10713/9159
dc.description.abstractlder patients are at increased risk of toxicities from aggressive oncologic therapy and of nononcologic death. A meta‐analysis of non‐nasopharyngeal head and neck cancers showed no statistical benefit in adding chemotherapy to radiotherapy (RT) in older patients; another meta‐analysis of RT versus chemoradiotherapy (CRT) in NPC found advantages to CRT, but vastly under‐represented patients ≥70 years old. This is the largest study to date evaluating outcomes of CRT versus RT alone in this population. The National Cancer Data Base (NCDB) was queried for primary nasopharyngeal cancer cases (2004–2013) in patients ≥70 years old receiving RT alone or CRT. Patients with unknown RT/chemotherapy and T1N0 or M1 disease were excluded. Logistic regression analysis ascertained factors associated with CRT delivery. Kaplan–Meier analysis evaluated overall survival (OS) between both cohorts. Cox proportional hazards modeling determined variables associated with OS. In total, 930 patients were analyzed (n = 713 (77%) CRT, n = 217 (23%) RT). Groups were relatively balanced; CRT was less frequently delivered in patients with advancing age, lower nodal burden, and females (P < 0.05 for all). Median OS in the CRT and RT groups were 35.3 versus 20.0 months, respectively (P = 0.002). On multivariate analysis, independent predictors of OS included age, comorbidities, income and insurance status, tumor grade, and stage (P < 0.05 for all). Notably, receipt of chemotherapy independently predicted for improved OS (P = 0.036). CRT, compared to RT alone, was independently associated with improved survival in NPC patients ≥70 years old. CRT appears to be a promising approach in this population, but treatment‐related toxicity risks should continue to be weighed against potential oncologic benefits. Copyright 2018 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.en_US
dc.description.urihttps://dx.doi.org/10.1002/cam4.1290en_US
dc.language.isoen_USen_US
dc.publisherBlackwell Publishing Ltden_US
dc.relation.ispartofCancer Medicine
dc.subjectChemotherapyen_US
dc.subjectelderlyen_US
dc.subjectgeriatricen_US
dc.subjectnasopharyngeal canceren_US
dc.subjectnasopharynxen_US
dc.subjectradiation therapyen_US
dc.titlePractice patterns and outcomes of chemoradiotherapy versus radiotherapy alone for older patients with nasopharyngeal canceren_US
dc.typeArticleen_US
dc.identifier.doi10.1002/cam4.1290


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