Clinical oncology (Royal College of Radiologists (Great Britain)) · 2026
Concordance Between Planned and Delivered treatment for Head and Neck Cancer Patients Treated With Curative Intent: A Real-World Comparison of Under 70-year-olds With 70-year-olds and Over.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Hargreaves S, Nixon I, Stewart K, Dudding T
Аннотация
INTRODUCTION: There is little published data on real world curative treatment planning and outcomes for older patients. We used this cohort to assess whether age ≥70yrs was associated with different planned treatment modalities, or reduced concordance between treatment planned and treatment delivered, compared to younger participants. In addition, we looked at the additional impact of co-morbidity scores and health-related quality of life outcomes.
METHODS: We included participants with primary tumours in the oral cavity, oropharynx or larynx who were planned for curative intent treatment within 4 months of study consent. Concordance between treatment planned and treatment delivered for each age group and subsite was calculated. Health-related quality of life was measured using EORTC QLQ-C30 and QLQ-H&N35. ACE27 co-morbidity scores were used to assess impact of co-morbidity.
RESULTS: 3939 patients were included in our analysis. Patient-related demographics were well matched between the two age groups. Participants ≥70 years were more likely to be diagnosed with laryngeal cancer and present with early-stage disease. Planned treatment modalities differed between age groups predominantly driven by the addition of concurrent chemotherapy to definitive or adjuvant radiotherapy in the younger age group. Concordance was generally high throughout, however, a larger proportion of participants received adjuvant treatment than was planned in late-stage laryngeal cancer in the ≥70 years group.
CONCLUSIONS: Delivered treatment in the real-world clinic often mirrors the treatment planned regardless of patient age. Only severe levels of co-morbidity reduce concordance. Omission of concurrent chemotherapy drives most of the difference between age groups. Older patients remain fit enough for their planned curative intent treatment.
METHODS: We included participants with primary tumours in the oral cavity, oropharynx or larynx who were planned for curative intent treatment within 4 months of study consent. Concordance between treatment planned and treatment delivered for each age group and subsite was calculated. Health-related quality of life was measured using EORTC QLQ-C30 and QLQ-H&N35. ACE27 co-morbidity scores were used to assess impact of co-morbidity.
RESULTS: 3939 patients were included in our analysis. Patient-related demographics were well matched between the two age groups. Participants ≥70 years were more likely to be diagnosed with laryngeal cancer and present with early-stage disease. Planned treatment modalities differed between age groups predominantly driven by the addition of concurrent chemotherapy to definitive or adjuvant radiotherapy in the younger age group. Concordance was generally high throughout, however, a larger proportion of participants received adjuvant treatment than was planned in late-stage laryngeal cancer in the ≥70 years group.
CONCLUSIONS: Delivered treatment in the real-world clinic often mirrors the treatment planned regardless of patient age. Only severe levels of co-morbidity reduce concordance. Omission of concurrent chemotherapy drives most of the difference between age groups. Older patients remain fit enough for their planned curative intent treatment.