Non Elective Vulnerable Elderly Radiotherapy

Summary

To evaluate whether patients defined "non-fit for curative non-surgical radio-chemotherapy" and therefore treated with RT alone addressed only to non-elective sites of disease, could obtain a non-inferior loco-regional control compared to similar historical cohorts.

Eligibility

Inclusion Criteria:

* locally advanced non-metastatic HNSCC patients older than 70 years
* Primary tumor clinically and radiologically detectable and measurable (staging according to ed. TNM VII and also VIII.
* patients defined by the tumor board (ENT, Oncologist, Radiotherapist, Nutritionist) as 1) not eligibles for RTCT / RT-cetuximab treatment 2) not amenable to radical surgery and 3) not candidates for treatments with palliative intent/best supportive care
* Availability of staging with CT/PET for distant metastasis and CT/MRI for primary tumor
* Karnofsky performance status (KPS) ≥60/100
* Oropharynx , Hypopharynx and Larynx, Oral cavity: stage III and IV and Unknown primitive P16-POSITIVE

Exclusion Criteria:

* Age less than 70 years

  * Staging exams done 45 days before the date of the beginning of the treatment
  * Subsites: nasopharynx, salivary glands, paranasal sinuses. Metastatic disease
  * Gross total excision
  * All subsites concerned if N3.
  * Squamous cell neoplasms of the glottic larynx T1-T2 N0.
  * Unknown primary HPV negative or EBV positive.
  * Presence of distant metastases or sub-clavicular lymphadenopathies.
  * Previous surgery on T and/or N except diagnostic tonsillectomy.
  * 3D-conformational radiotherapy technique

Conditions2

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