(080) Evaluating Tolerability of Concurrent Weekly Cisplatin and Radiation in Geriatric Head and Neck Cancer Patients

Poster Abstract: Background
Head and neck cancers include a variety of malignancies that originate from different anatomical sites in the aerodigestive tract and are typically diagnosed in patients over the age of 50. However, the incidence in adults younger than 45 years has increased due to increasing cases associated with oncogenic human papillomavirus.

Squamous cell carcinoma of the head and neck accounts for more than 90% of head and neck cancers. Treatment is usually multi-modal and can include surgery, radiation, chemotherapy, targeted therapy, or a combination of any aforementioned treatment options. Cisplatin, carboplatin, paclitaxel, and cetuximab are commonly used in head and neck cancers. High-dose cisplatin has established survival benefits for patients with good performance scores, however, due to the toxicities of cisplatin, older patients are often excluded. Current National Comprehensive Cancer Network (NCCN) guidelines for non-nasopharyngeal cancers prefers high-dose cisplatin as the preferred regimen given concurrently with radiation for curative intent. Alternatively, weekly cisplatin may be used.

There is minimal literature evaluating the use of cisplatin in geriatric patients and there is a need to understand the tolerability in this patient population. Our study aims to provide additional literature to this area.

Objective
This primary objective of this study is to evaluate the tolerability of concurrent weekly cisplatin and radiation in patients 70 years of age and older with head or neck cancer.

Methods
This study is a retrospective cohort study of patients 70 years of age and older with a diagnosis of squamous cell carcinoma of the head or neck. Patients should have been treated at The University of Texas MD Anderson Cancer Center with concurrent weekly cisplatin and radiation as their primary treatment modality between March 4, 2016, and June 30, 2023. Patients that have had surgery for their head or neck cancer immediately prior to concurrent chemoradiation, have cancer of the nasopharynx or salivary gland, or have recurred within 2 years of previous therapy will be excluded. Baseline demographics and adverse events will be collected for each patient from the institutional electronic medical record. The primary endpoint is to evaluate the discontinuation rate and cause of discontinuation of weekly cisplatin in patients 70 years of age and older receiving concurrent radiation.

Results: results pending

Discussion: pending results

Conclusion: pending results

References (must also be included in final poster): 1. Mody MD, Rocco JW, Yom SS, Haddad RI, Saba NF. Head and neck cancer. Lancet. 2021;398(10318):2289-2299.
2. Chow LQM. Head and Neck Cancer. N Engl J Med. 2020;382(1):60-72.
3. NCCN Guidelines Insights: Head and Neck Cancers, Version 2.2024, 12/08/2023 in: Journal of the National Comprehensive Cancer Network
Version 2.2024.