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@ARTICLE{Rhle:271248,
author = {A. Rühle$^*$ and S. Marschner$^*$ and M. Haderlein and A.
Fabian and M. Weymann and M. Behrens and C. Senger$^*$ and
D. R. Dickstein and J. Kraft and J. von der Grün$^*$ and E.
Chen and T. Aquino-Michaels and J. Domschikowski and A.
Bickel and A. Altay-Langguth$^*$ and G. Kalinauskaite$^*$
and V. Lewitzki and K. Ferentinos and C. Zamboglou$^*$ and
S. Schnellhardt and E. Haehl$^*$ and S. K. B. Spohn$^*$ and
E. Gkika$^*$ and D. Zöller and M. Guckenberger and V.
Budach$^*$ and C. Belka$^*$ and R. Bakst and A. Mayer$^*$
and H. Schmidberger$^*$ and A.-L. Grosu$^*$ and P. Balermpas
and C. Stromberger$^*$ and N. Nicolay$^*$},
title = {{E}valuation of {C}oncomitant {S}ystemic {T}reatment in
{O}lder {A}dults {W}ith {H}ead and {N}eck {S}quamous {C}ell
{C}arcinoma {U}ndergoing {D}efinitive {R}adiotherapy.},
journal = {JAMA network open},
volume = {6},
number = {2},
issn = {2574-3805},
address = {Chicago, Ill.},
publisher = {American Medical Association},
reportid = {DKFZ-2023-00380},
pages = {e230090},
year = {2023},
abstract = {The number of older adults with head and neck squamous cell
carcinoma (HNSCC) is increasing, and these patients are
underrepresented in clinical trials. It is unclear whether
the addition of chemotherapy or cetuximab to radiotherapy is
associated with improved survival in older adults with
HNSCC.To examine whether the addition of chemotherapy or
cetuximab to definitive radiotherapy is associated with
improved survival in patients with locoregionally advanced
(LA) HNSCC.The Special Care Patterns for Elderly HNSCC
Patients Undergoing Radiotherapy (SENIOR) study is an
international, multicenter cohort study including older
adults (≥65 years) with LA-HNSCCs of the oral cavity,
oropharynx/hypopharynx, or larynx treated with definitive
radiotherapy, either alone or with concomitant systemic
treatment, between January 2005 and December 2019 at 12
academic centers in the US and Europe. Data analysis was
conducted from June 4 to August 10, 2022.All patients
underwent definitive radiotherapy alone or with concomitant
systemic treatment.The primary outcome was overall survival.
Secondary outcomes included progression-free survival and
locoregional failure rate.Among the 1044 patients (734 men
$[70.3\%];$ median [IQR] age, 73 [69-78] years) included in
this study, 234 patients $(22.4\%)$ were treated with
radiotherapy alone and 810 patients $(77.6\%)$ received
concomitant systemic treatment with chemotherapy (677
$[64.8\%])$ or cetuximab (133 $[12.7\%]).$ Using inverse
probability weighting to attribute for selection bias,
chemoradiation was associated with longer overall survival
than radiotherapy alone (hazard ratio [HR], 0.61; $95\%$ CI,
0.48-0.77; P < .001), whereas cetuximab-based
bioradiotherapy was not (HR, 0.94; $95\%$ CI, 0.70-1.27; P =
.70). Progression-free survival was also longer after the
addition of chemotherapy (HR, 0.65; $95\%$ CI, 0.52-0.81; P
< .001), while the locoregional failure rate was not
significantly different (subhazard ratio, 0.62; $95\%$ CI,
0.30-1.26; P = .19). The survival benefit of the
chemoradiation group was present in patients up to age 80
years (65-69 years: HR, 0.52; $95\%$ CI, 0.33-0.82; 70-79
years: HR, 0.60; $95\%$ CI, 0.43-0.85), but was absent in
patients aged 80 years or older (HR, 0.89; $95\%$ CI,
0.56-1.41).In this cohort study of older adults with LA-
HNSCC, chemoradiation, but not cetuximab-based
bioradiotherapy, was associated with longer survival
compared with radiotherapy alone.},
cin = {FR01 / MU01 / BE01 / FM01},
ddc = {610},
cid = {I:(DE-He78)FR01-20160331 / I:(DE-He78)MU01-20160331 /
I:(DE-He78)BE01-20160331 / I:(DE-He78)FM01-20160331},
pnm = {899 - ohne Topic (POF4-899)},
pid = {G:(DE-HGF)POF4-899},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:36808242},
doi = {10.1001/jamanetworkopen.2023.0090},
url = {https://inrepo02.dkfz.de/record/271248},
}