Acute toxicity rate is high in elderly patients with advanced head and neck squamous cell carcinoma (HNSCC) undergoing chemotherapy and radiation therapy (CTRT), according to a study published online ahead of print in Cancer.

“It is possible that for certain older patients, the potential benefit of adding chemotherapy to radiation therapy does not outweigh the harms of this combined-modality therapy,” said researchers led by Caitriona B. O’Neill, PhD, of the Memorial Sloan-Kettering Cancer Center.

Through SEER-Medicare registry data, she and her colleagues identified patients aged 66 years or older who were diagnosed with locally advanced HNSCC from 2001 to 2009 and were receiving CTRT or radiation therapy alone.

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They looked for toxicity-related hospital admissions, emergency room visits and rate of feeding tube use while controlling for demographic and disease characteristics.

Among 1502 patients who were receiving CTRT, 62 percent were found to have treatment-related toxicity, compared to 775 patients who received radiation therapy alone with 46 percent experiencing toxicity.

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When controlled for demographic and disease characteristics, they also found that patients treated with CTRT were twice as likely to experience acute toxicity compared to those who underwent radiation therapy alone.

Fifty-five percent of patients treated with CTRT had a feeding tube placed in the course of treatment, compared to 28 percent in the radiation therapy alone group.


  1. O’Neill, Caitriona B., PhD, et al. “Treatment-related toxicities in older adults with head and neck cancer: A population-based analysis.” Cancer. DOI: 10.1002/cncr.29262. [epub ahead of print]. February 27, 2015.