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Войти в исследования Clinical oncology (Royal College of Radiologists (Great Britain)) · 2026
Patient Reported Outcome Measures of Head and Neck Cancer Patients Treated With Curative Intent Radiotherapy Within the Head and Neck 5000 Cohort.
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Growcott S, Dembrey T, Odding Y, Bellou E, Dudding T, Hargreaves S
Аннотация
AIMS: We used the Head and Neck 5000 (HN5000) cohort to assess whether age ≥70 yrs and World Health Organization (WHO) performance status (PS) ≥2 were associated with increased severity of patient-reported acute, late, and very late toxicity or reduced rate of completing a prescribed course of radiotherapy (RT) with or without concurrent systemic anticancer treatment (SACT) in patients undergoing radical treatment for oral cavity, oropharyngeal, and laryngeal cancer.
MATERIALS AND METHODS: Participants treated with definitive or adjuvant RT with/without concurrent SACT were included. Baseline characteristics were analysed with the chisquared and Wilcoxon rank-sum test. Patient-reported outcomes (PROs) were stratified into age <70 yrs vs ≥70 yrs, and PS <2 vs PS ≥2 and investigated across all timepoints per head and neck cancer (HNC) tumour subsite and as an overall cohort using longitudinal modelling, multivariable analysis, and sensitivity analysis. The odds of completing the RT rate was calculated, and differences were assessed using Fisher's exact test.
RESULTS: A total of 3250 patients were included in the age-group analysis, and 2295 were included in the PS analysis. PROs reporting reduced over time, especially for the PS ≥2 group; 1971 were included in the multivariable analysis. Participants ≥70 yrs reported symptom severity similar to or lower than those <70 yrs. High PRO scores were consistently more likely among those who were PS ≥2 compared with PS <2, and recovery was generally slower and poorer. Completion rates of RT were very high, regardless of age or PS, with >97% completing definitive and >94% completing adjuvant RT.
CONCLUSION: Age does not appear to be a negative prognostic factor for PROs following radical RT for HNC. Despite reporting higher toxicity, surprisingly, PS ≥2 patients often completed a radical RT course regardless. In an ageing population with an increasing incidence of HNC, more detailed research is required to better inform our clinical management of this underrepresented patient cohort.
MATERIALS AND METHODS: Participants treated with definitive or adjuvant RT with/without concurrent SACT were included. Baseline characteristics were analysed with the chisquared and Wilcoxon rank-sum test. Patient-reported outcomes (PROs) were stratified into age <70 yrs vs ≥70 yrs, and PS <2 vs PS ≥2 and investigated across all timepoints per head and neck cancer (HNC) tumour subsite and as an overall cohort using longitudinal modelling, multivariable analysis, and sensitivity analysis. The odds of completing the RT rate was calculated, and differences were assessed using Fisher's exact test.
RESULTS: A total of 3250 patients were included in the age-group analysis, and 2295 were included in the PS analysis. PROs reporting reduced over time, especially for the PS ≥2 group; 1971 were included in the multivariable analysis. Participants ≥70 yrs reported symptom severity similar to or lower than those <70 yrs. High PRO scores were consistently more likely among those who were PS ≥2 compared with PS <2, and recovery was generally slower and poorer. Completion rates of RT were very high, regardless of age or PS, with >97% completing definitive and >94% completing adjuvant RT.
CONCLUSION: Age does not appear to be a negative prognostic factor for PROs following radical RT for HNC. Despite reporting higher toxicity, surprisingly, PS ≥2 patients often completed a radical RT course regardless. In an ageing population with an increasing incidence of HNC, more detailed research is required to better inform our clinical management of this underrepresented patient cohort.