PT  - JOURNAL ARTICLE
AU  - ANNEKE FRYEN
AU  - IRIS BRANDES
AU  - JÖRN WICHMANN
AU  - HANS CHRISTIANSEN
AU  - FRANK TAVASSOL
AU  - MARTIN DURISIN
AU  - ROLAND MERTEN
TI  - Moderately Hypofractionated Radiotherapy Without Chemotherapy in Elderly or Frail Patients With Head and Neck Cancer
AID  - 10.21873/invivo.12825
DP  - 2022 May 01
TA  - In Vivo
PG  - 1259--1266
VI  - 36
IP  - 3
4099  - http://iv.iiarjournals.org/content/36/3/1259.short
4100  - http://iv.iiarjournals.org/content/36/3/1259.full
SO  - In Vivo2022 May 01; 36
AB  - Background: Comorbidity and frailty are relevant limitations of normofractionated combined radiochemotherapy for squamous cell head and neck cancer (HNSCC), especially in elderly patients. This retrospective study aimed to evaluate the efficacy and toxicity of moderately hypofractionated radiotherapy (HRT) without chemotherapy in patients ineligible for concurrent radiochemotherapy. Patients and Methods: Between 2011 and 2018, 51 elderly/frail patients with HNSCC were treated with either definitive (n=23) or adjuvant (n=28) moderate HRT. A dose of 45 Gy was given to the primary tumour region and cervical nodes with a sequential boost up to 50 in the adjuvant and 55 Gy in the definitive cure setting (2.5 Gy/fraction). Patient outcomes of locoregional control, overall survival, and acute and late toxicity were analysed. Results: After a median follow-up of 6 months for the definitive HRT group and 28.5 months for the adjuvant HRT group, we found a median overall survival of 6 vs. 55 months (log-rank test: p<0.001) and a median locoregional control of 9 months vs. not reached (log-rank test: p=0.008), respectively. The 2-year rates of locoregional control were 28.5% for the definitive HRT group vs. 75.2% for the adjuvant HRT group. No acute or late grade 4-5 toxicity occurred; grade 3 toxicity was rarely documented. Conclusion: HRT in elderly/frail patients with HNSCC who are unfit for chemotherapy leads to acceptable local control with moderate toxicity in a short overall treatment time. Especially in the postoperative situation, HRT can be considered an appropriate alternative to normofractionated radio(chemo)therapy. Definitive HRT can be a treatment alternative, especially for multimorbid patients.