Abstract
Objective: 1) Determine if an association exists between age and overall survival (OS) and progression-free survival (PFS) in induction chemotherapy (IC) for head and neck cancer (HNC). 2) Compare age-specific response to 2 different chemotherapy regimen in HNC.
Method: A total of 501 patients enrolled on TAX 324 study (1999 to 2003) were evaluated. Patients had nonmetastatic, unresectable stage III/IV HNC. A total of 255 patients received IC with docetaxel, cisplatin, 5FU (TPF), and 246 received cisplatin, 5 fluorouracil (PF). The cohort was split into 2 groups; 55 years.
Results: Fisher exact test and general linear model approach compared clinical and demographic characteristics between treatment arms. Kaplan-Meir method estimated OS and PFS. Stepwise Cox regression modeled OS and PFS functions. A total of 249 patients were 55 years, 127 were assigned to TPF arm and 125 to PF arm, Total failures reached statistical significance between the 2 arms; there were 50 total failures in the TPF arm and 58 in the PF arm (0.65, 0.42-0.98; 0.04).
Conclusion: Our study contradicts the small amount of published evidence on age-specific responses to chemotherapy regimen in breast, prostate, and lung cancer. It is the first study of its kind evaluating the role of age in overall survival in chemotherapy in HNC.
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