TY  - JOUR
AU  - Rühle, Alexander
AU  - Stromberger, C.
AU  - Haehl, E.
AU  - Senger, C.
AU  - Falkenstein, A. E.
AU  - Stoian, R. G.
AU  - Zamboglou, C.
AU  - Knopf, A.
AU  - Budach, V.
AU  - Grosu, A. L.
AU  - Nicolay, Nils
TI  - Development and External Validation of a Prognostic Classifier for Elderly Head-and-Neck Cancer Patients Undergoing (Chemo)radiation.
JO  - International journal of radiation oncology, biology, physics
VL  - 111
IS  - 3S
SN  - 0360-3016
CY  - Amsterdam [u.a.]
PB  - Elsevier Science
M1  - DKFZ-2021-02363
SP  - e378
PY  - 2021
N1  - #EA:E055#LA:E055#
AB  - Elderly head-and-neck squamous cell carcinoma (HNSCC) patients form a heterogeneous cohort, and survival estimation is often challenging due to underlying comorbidities. Prognostic classifiers and nomograms may therefore be useful for overall survival (OS) estimation in order to provide shared decision-making in the clinical routine.A total of 284 elderly HNSCC patients aged ≥65 years who received a curative (chemo)radiation between 2010 and 2020 at a tertiary cancer center were used for the development of a survival classifier. On the basis of a multivariate Cox regression analysis, significant parameters were identified for which points were given according to the beta regression values. The derived classifier was then validated in a second, external cohort consisting of 217 elderly HNSCC patients undergoing (chemo)radiation. Based on the cumulative data of 501 patients, a nomogram for the 2-year and 4-year OS was created. We then examined in a third independent cohort whether the classifier could also stratify the prognosis of surgically treated elderly HNSCC patients without adjuvant (chemo)radiation (n = 169).In the multivariate backward stepwise Cox regression with likelihood ratio tests using P < 0.1 as inclusion criterion, the Karnofsky Performance Status (KPS, HR = 2.654, P < 0.001), the age-adjusted Charlson Comorbidity Index (CCI, HR = 2.598, P < 0.001) and the pre-radiotherapy CRP serum concentration (HR = 1.634, P = 0.064) were significant prognostic parameters for OS. Following the beta regression values, a KPS ≤70
LB  - PUB:(DE-HGF)16
C6  - pmid:34701311
DO  - DOI:10.1016/j.ijrobp.2021.07.1110
UR  - https://inrepo02.dkfz.de/record/177229
ER  -