280P Safety and efficacy of concurrent chemoradiotherapy for head and neck cancers in younger versus older patients: Post hoc analysis of a randomized control trial

Abstract

Head and neck squamous cell carcinoma (HNSCC) is a well-known malignancy in the older population. However, there is scarcity of data on the effect of chemoradiation on them. We did a posthoc analysis of a randomized study conducted at our institution to understand this effect. We did a posthoc analysis of the study where the patients received chemoradiation. The database of this study was used for the present analysis. We evaluated the differences in demography, grade 3 or worse adverse events, compliance of treatment, loco-regional control (LRC), progression free survival (PFS) and overall survival (OS) between older (≥ 60 years) and the younger patients. Out of 300 patients, 283 (94.3%) comprised the younger cohort (age < 60 years) while the older cohort included 17 (5.7%) patients. There was no difference in the occurrence of severe (grade 3/4) toxicities in the older cohort when compared to the younger patients. At a median follow up period of 22 months (range, 3-51), the cumulative LRC at 2 years was 67.1% and 100% in younger and the older group respectively (P = 0.018). The estimated median PFS in younger patients was 24.4 months (95% CI, 12.5 to 36.3), while it was not reached in the older group (P = 0.53). The estimated median OS was 41.3 months in the younger and not reached in the older group (P = 0.613). Older patients with locally advanced HNSCC who received radical concurrent cisplatin-based chemoradiotherapy showed significantly better LRC. Older patients experienced similar adverse events as compared to the younger ones.