Differences In Patterns Of Care In Older Vs. Younger Head And Neck Cancer Patients.

e18079 Background: Treatment of head and neck squamous cell carcinoma (HNSCC) with multimodality therapy has improved locoregional control and overall survival. No benefit has been shown in patients over age 70. We evaluated patterns of care in older (≥65) vs. younger patients receiving curative-intent therapy. Methods: An institutional database was queried for patients diagnosed with HNSCC between January 2012 and May 2017, for whom curative-intent therapy was planned. Patients were stratified into a younger cohort (age 18-64 years) and an older cohort (≥ 65 years). Radiation treatment intent, use of chemotherapy, and completion of planned treatments were evaluated. Descriptive statistics were incorporated with Chi-squared or Fisher’s exact test. Logistic regression was used to estimate associations between age, stage, and chemotherapy received. Results: A total of 409 patients were identified, with 130 older patients. There was no difference in adjuvant vs. definitive treatment intent by age group (P = 0.54). Younger age was associated with higher likelihood of completing planned radiation dose (63.6% vs.28%, P = 0.04). There was no difference in variability of number of radiation days between the older and younger cohorts (49.6 ± 36.1 days, vs. 51.3 ± 13 days). Patients in the older subset were more likely to be treated with radiation alone (48.5% vs. 24.7%, P < 0.001), and less likely to be treated with a platinum-based regimen (47% vs. 69%, P < 0.001). Adjusted for T- and N-stage, there was a statistical trend between age and chemotherapy agent (P = 0.093); compared to receiving no chemotherapy, younger patients were 1.9 times more likely to receive a cisplatin-containing regimen compared to older patients (95% CI, 1.06-3.44). Conclusions: Older patients with HNSCC treated with curative therapy are less likely to receive chemotherapy, and less likely to receive platinum agents, compared to younger patients. Further study is needed to define populations of older adults who may better tolerate combined modality therapy.