Indications for chemoradiotherapy in older patients with locally advanced head and neck cancer in Japan: a questionnaire survey in the JCOG head and neck cancer study group

Koichi Yasuda; Naomi Kiyota; Kazuto Matsuura; Satoshi Saito; Yoshitaka Honma; Yoshinori Imamura; Kaoru Tanaka; Sadamoto Zenda; Takuma Onoe; Takeshi Kodaira; Satoshi Kobayashi; Hidefumi Aoyama; Nobuhiro Hanai; Akihiro Homma

doi:10.3389/fonc.2024.1441056

Indications for chemoradiotherapy in older patients with locally advanced head and neck cancer in Japan: a questionnaire survey in the JCOG head and neck cancer study group

Front Oncol. 2025 Jan 8:14:1441056. doi: 10.3389/fonc.2024.1441056. eCollection 2024.

Authors

Affiliations

¹ Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan.
² Department of Medical Oncology and Hematology, Cancer Center, Kobe University Hospital, Kobe, Japan.
³ Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan.
⁴ Department of Radiation Oncology, Saitama Medical University International Medical Center, Hidaka, Japan.
⁵ Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.
⁶ Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Japan.
⁷ Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan.
⁸ Department of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Kashiwa, Japan.
⁹ Division of Medical Oncology, Hyogo Cancer Center, Akashi, Japan.
¹⁰ Department of Radiation Oncology, Aichi Cancer Center Hospital, Aichi, Japan.
¹¹ Department of Gastroenterology, Kanagawa Cancer Center, Yokohama, Japan.
¹² Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
¹³ Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
¹⁴ Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.

Abstract

Introduction: Chemoradiation therapy (CRT) with concurrent high-dose cisplatin (CDDP) is one of the standard treatment options for locally advanced head and neck cancer. Since the indications specific to the older population have not been reported, we conducted a multicenter survey on the indications.

Methods: In April and May 2023, a questionnaire survey was emailed to all institutions belonging to the JCOG-HNCSG, consisting of 37 institutions.

Results: The major factors influencing the indications for high-dose CDDP were renal function and performance status (PS). The majority agreed that the treatment is administered to patients aged 65-74 years with PS 0-1 and 65-74 years with eGFR ≥60 (ml/ min/1.73m2), and not in patients aged ≥75 years with PS 2, ≥80 years with PS 1, and ≥65 years with eGFR <60. Regarding weekly CDDP, the majority agreed that the treatment is not conducted in patients aged ≥75 years with PS 2, ≥65 years with eGFR <40, and ≥70 years with eGFR <50.

Discussion: In Japan, where CRT is actively performed even among older people, a survey was conducted to determine its indications. Renal function and PS were considered important, and comorbidities, such as heart failure, were considered while determining the indication. These results will help define the eligibility criteria for prospective studies on CRT in older patients.

Keywords: chemoradiotherapy; cisplatin; head and neck cancer; older patients; radiotherapy.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work is partially supported by the National Cancer Center Research and Development Funds (2023-J-3).