Variations in Treatment Prescription and Survival Outcomes Between Older and Younger Patients With Mucosal Head and Neck Squamous Cell Carcinoma Treated With Radiotherapy

PURPOSE: To investigate treatment variations and outcomes between older (≥ 70 years) and younger (< 70 years) patients with mucosal head and neck squamous cell carcinoma (mHNSCC) treated with radiotherapy. METHODS: A multicenter retrospective review of patients diagnosed from 2010 to 2018 was conducted. Patient, tumor, and treatment data were collected, including overall survival (OS) and progression-free survival (PFS). Multivariable analyses examined factors influencing standard-of-care (SOC) treatment, OS, and PFS. RESULTS: Of 1553 patients, 432 patients were ≥ 70 years. Older patients were significantly less likely to receive curative treatment, SOC, or concurrent systemic therapy. Age, marital status, ECOG status, stage, and subsite influenced SOC treatment. Three-year OS and PFS were lower in older patients. ECOG status, stage, subsite, and SOC treatment were significantly associated with OS and PFS. Older age and smoking status were significantly associated with lower OS but not PFS. CONCLUSIONS: Older patients should be offered SOC treatment where appropriate for maximal disease control and survival.