Impact of stereotactic body radiation therapy on geriatric assessment and management for older patients with head and neck cancer using G8

Gogineni, Emile; Rana, Zaker; Wotman, Michael; Karten, Jessie L.; Riegel, Adam C.; Marrero, M.; Maduro, Luís; Kamdar, Dev; Frank, Douglas K.; Paul, Doru; Seetharamu, Nagashree; Ghaly, Maged

doi:10.1016/j.jgo.2020.06.023

Cited by 7 publications

(2 citation statements)

References 32 publications

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“…21,22 Lastly, use of novel geriatric assessment scores, which include factors such as ECOG, KPS, and CCI scores, may further guide clinical discussions with senior adult patients initiating RT. 23,24 While the results of this study are clinically meaningful, the present study is limited in several ways beyond its single-institution retrospective design and moderate sample size. First, there are several variables that may have contributed to a patient's treatment termination decision, such as palliative intent, mode of transportation, time length of treatment commute, necessary employment and caregiver responsibilities, or financial toxicity of daily treatment.…”

Section: Discussionmentioning

confidence: 94%

“…Additional preventative measures may include increasing patient support and screening for mental health conditions prior and throughout RT, as depressive symptomatology and lack of social support have been shown to correlate with discontinuation of follow‐up care in patients with HNC 21,22 . Lastly, use of novel geriatric assessment scores, which include factors such as ECOG, KPS, and CCI scores, may further guide clinical discussions with senior adult patients initiating RT 23,24 …”

Section: Discussionmentioning

confidence: 99%

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Clinical predictors of premature radiotherapy terminations in senior adults with oral cavity and laryngeal carcinoma

Cooper,

Travaglia,

Guller

et al. 2023

Head & Neck

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IntroductionThe underlying factors that contribute to early radiotherapy (RT) termination are understudied, especially in the era of hypofractionated treatment regimens. In this retrospective investigation, we examined the characteristics and causes of premature RT terminations in senior adults (>70 years old) with oral cavity (OC) and laryngeal carcinomas.MethodsHundred and eighty‐eight patients treated with RT ± systemic therapy for OC and laryngeal cancer from 2017 to 2022 were identified. Premature termination was defined as completion of less than 95% of the prescribed RT. Logistic regression analysis was performed to examine factors predictive of premature termination, and survival was determined using the Kaplan–Meier method.ResultsTwenty patients (10.6%) experienced premature RT terminations. On regression analysis, ECOG score at initiation of RT was the only covariate studied to be independently associated with premature termination (OR 2.00, 95%CI: [1.21, 3.30], p = 0.007). Three‐year overall survival (49.1% vs. 77.3%) was significantly reduced in the termination cohort (p < 0.0001).ConclusionsThis analysis demonstrated over 1 in 10 patients had premature RT termination, which prognosticated inferior survival outcomes. Poor performance status may highlight patients at risk for premature termination and thus identify good candidates for hypofractionated protocols.

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