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@ARTICLE{Haehl:169198,
      author       = {E. Haehl$^*$ and A. Rühle$^*$ and R. Klink$^*$ and T.
                      Kalckreuth$^*$ and T. Sprave$^*$ and E. Gkika$^*$ and C.
                      Zamboglou$^*$ and F. Meiß and A.-L. Grosu$^*$ and N.
                      Nicolay$^*$},
      title        = {{T}he value of primary and adjuvant radiotherapy for
                      cutaneous squamous cell carcinomas of the head-and-neck
                      region in the elderly.},
      journal      = {Radiation oncology},
      volume       = {16},
      number       = {1},
      issn         = {1748-717X},
      address      = {London},
      publisher    = {BioMed Central},
      reportid     = {DKFZ-2021-01322},
      pages        = {105},
      year         = {2021},
      note         = {#LA:E055#},
      abstract     = {To examine treatment patterns, oncological outcomes and
                      toxicity rates in elderly patients receiving radiotherapy
                      for cutaneous squamous cell carcinoma (cSCC) of the
                      head-and-neck region.In this retrospective single-center
                      analysis, locoregional control (LRC), progression-free
                      survival (PFS) and overall survival (OS) of elderly patients
                      > 65 years with cSCC of the head-and-neck region undergoing
                      radiotherapy between 2010 and 2019 were calculated. The
                      prognostic value of clinicopathological parameters on
                      radiotherapy outcomes was analyzed using the Cox
                      proportional hazards model. In addition, both acute and
                      chronic toxicities were retrospectively quantified according
                      to CTCAE version 5.0.A total of 69 elderly patients with
                      cSCC of the head-and-neck region with a median age of
                      85 years were included in this analysis, of whom $21.7\%$
                      (15 patients) presented with nodal disease. The majority of
                      patients exhibited a good performance status, indicated by a
                      median Karnofsky performance status (KPS) and Charlson
                      Comorbidity Index (CCI) of $80\%$ and 6 points,
                      respectively. Radiotherapy was administered as primary
                      $(48\%),$ adjuvant $(32\%)$ or palliative therapy $(20\%).$
                      55 patients $(79.7\%)$ completed treatment and received the
                      scheduled radiotherapy dose. Median EQD2 radiation doses
                      were 58.4 Gy, 60 Gy and 51.3 Gy in the definitive,
                      adjuvant and palliative situation, respectively. 2-year LRC,
                      PFS and OS ranged at $54.2\%,$ 33.5 and $40.7\%,$
                      respectively. Survival differed significantly between age
                      groups with a median OS of 20 vs. 12 months (p < 0.05) for
                      patients aged 65-80 or above 80 years. In the multivariate
                      analysis, positive lymph node status remained the only
                      significant prognostic factor deteriorating OS (HR 3.73, CI
                      1.54-9.03, p < 0.01). Interestingly, neither KPS nor CCI
                      impaired survival in this elderly patient cohort. Only 3
                      patients $(4.3\%)$ experienced acute CTCAE grade 3
                      toxicities, and no chronic CTCAE grade 2-5 toxicities were
                      observed in our cohort.Radiotherapy was feasible and
                      well-tolerated in this distinct population, showing the
                      general feasibility of radiotherapy for cSCC of the
                      head-and-neck region also in the older and oldest olds. The
                      very mild toxicities may allow for moderate dose escalation
                      to improve LRC.},
      keywords     = {Cutaneous squamous cell carcinoma (Other) / Elderly (Other)
                      / Geriatric (Other) / Head-and-neck tumor (Other) /
                      Radiotherapy (Other)},
      cin          = {FR01 / E055},
      ddc          = {610},
      cid          = {I:(DE-He78)FR01-20160331 / I:(DE-He78)E055-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:34118984},
      doi          = {10.1186/s13014-021-01832-3},
      url          = {https://inrepo02.dkfz.de/record/169198},
}