Radiotherapy for elderly patients diagnosed with laryngeal carcinoma: A single center experience

Abstract

OBJECTIVE To evaluate the efficacy and toxicity of definitive and postoperative radiotherapy (RT) for laryngeal carcinoma patients aged ≥70 years. METHODS Data of patients between December 2006 and January 2016 were retrospectively analyzed. In total, 66 (4 females and 62 males) patients were evaluated for this analysis. The median age was 74 (range, 70–86 years) years. The total RT dose was 70 Gy and 60–66 Gy for definitive and postoperative settings with 2 Gy per fraction, respectively. RESULTS The median follow-up time was 29.5 (range, 4–126 months) months. Using the tumor, node, metastasis (TNM) classification, tumors were stage IIA (18.2%), stage IIIA (31.8%), stage IIIB (3%), and stage IVA (47%). The purpose of RT was definitive for 33 (50%) patients and postoperative for 33 (50%) patients. Concomitant chemotherapy was used in 21 (31%) patients with 9 (42%) receiving cetuximab and 12 (58%) receiving cisplatin. Cisplatin dose reduction was needed in 20% patients, but cetuximab was used as per a suggested protocol. The 3-year local relapse free (LRF), metastases free (MF), and overall survival rates for all patients were 74%, 84%, and 48%, respectively. Only 26 (40%) patients died due to disease specific problems, and 18 (27%) patients died of unknown causes. In the toxicity evaluation, no grade 3–4 adverse effect was seen. Any type of cytopenia status was reported in 14 (21%) patients, and this rate was statistically higher in concomitant radiochemotherapy group (p=003). CONCLUSION RT seems to be an effective therapy in elderly population either alone or concomitant with chemotherapy in definitive and postoperative settings. In contrast, comorbid diseases should be managed carefully in the treatment and follow-up periods.