The effect of age on outcome in prospective, phase III NRG Oncology/RTOG trials of radiotherapy (XRT) +/- chemotherapy in locally advanced (LA) head and neck cancer (HNC).

6003 Background: The effect of advanced age on outcome for single agent XRT and combined modality therapy in LA-HNC is not well defined. Methods: The effect of age (< 70 vs ≥ 70 years) on survival and toxicity was examined in LA-HNC patients (pts) on RTOG 9003 testing 3 altered fractionation (fx) XRT schedules versus standard daily XRT (SFX); RTOG 0129 comparing concurrent SFX + cisplatin (DDP) to accelerated fx with concomitant boost XRT (AFX-C) + DDP; and RTOG 0522, testing AFX-C + concurrent DDP +/- cetuximab. Results: Secondary analysis included 2,688 pts. Median followup for surviving pts was 5.2 years (range 0.01 to 20.3) overall, 14.1 yrs in RTOG 9003, 7.9 years in RTOG 0129, and 4.6 years in RTOG 0522. Pts age ≥ 70 were more likely to be female with poorer PS, heavier smoking history and p16 (-) status (p < 0.001 each). Adjusting for covariates, patients age ≥ 70 had worse survival regardless of smoking or p16 status. Adverse effect of patients age ≥ 70 may have been worse in p16 (+) pts (HR 2.07 ...