Clinical benefit of adding oxaliplatin to standard neoadjuvant chemoradiotherapy in locally advanced rectal cancer: a meta-analysis : Oxaliplatin in neoadjuvant treatment for rectal cancer
Abstract. Background: To evaluate the treatment tolerance
and clinical outcomes in patients aged 70 years and older with
locally advanced oropharyngeal cancer treated by definitive
intensity-modulated radiation therapy (IMRT). Patients and
Methods: We retrospectively analyzed 15 consecutive elderly
patients, with histologically-proven squamous cell carcinoma
of the oropharynx, staged T3-4 with or without involved lymph
nodes at diagnosis, who received definitive sequential IMRT
(70 Gy; 2 Gy/fraction). Adult Comorbidity Evaluation-27
(ACE-27) score was calculated and its influence on treatment
tolerance and clinical outcomes was analyzed. Results: A total
of 15 patients were included with a median age of 77 years
(range=70-88 years). At baseline, 8 patients (53.3%) had an
ACE-27 score of 1, and the remainder (n=7, 46.7%) had a
comorbidity index of 0. All patients completed programmed
IMRT treatment, without any reduction of total dose. Oral
pain and mucositis were the most common acute side-effects,
classified as grade 3 in 6 patients (40%) only. Xerostomia was
reported in 13 patients (86.7%), without severe manifestation.
There was no hematological toxicity. ACE-27 score was not
related to higher severe acute toxicity. No patients experienced
grade 3 or more late toxicity. Five-year overall survival and
disease-free survival rates were 63.6% (95% confidence
interval=32.7-83.3%) and 55% (95% confidence
interval=24.4-77.6%), respectively. Comorbidity score did not
influence survival outcomes, both overall survival (p=0.46)
and disease-free survival (p=0.55). Conclusion: Treatment
tolerance, as well as survival outcomes were good in elderly
oropharyngeal cancer patients treated with definitive
sequential IMRT. Due to age and comorbidity, no dose or
volume reduction for IMRT should be considered in this
setting of patients. A prospective randomized trial with a large
sample size should be conducted to confirm our result
