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Marschner, S. ; Maihöfer, C. ; Späth, R. ; Haehl, E. ; Reitz, D.* ; Kienlechner, N. ; Schüttrumpf, L. ; Baumeister, P. ; Pflugradt, U. ; Hess J. ; Zitzelsberger, H. ; Unger, K. ; Belka, C. ; Walter, F.

Adjuvant (chemo)radiotherapy for patients with head and neck cancer: Can comorbidity risk scores predict outcome?

Strahlenther. Onkol., DOI: 10.1007/s00066-024-02282-y (2024)
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PURPOSE: This study compares the objective American Society of Anesthesiologists (ASA) and Adult Comorbidity Evaluation-27 (ACE-27) scores with the subjective Eastern Cooperative Oncology Group performance status (ECOG PS) for patient outcome prediction. METHODS: We retrospectively analyzed head and neck squamous cell carcinoma patients treated with adjuvant (chemo)radiotherapy at the LMU Munich from June 2008 to June 2015. The study focused on associations between patient outcomes; treatment failures; known risk factors (including human papillomavirus [HPV] status and tumor stage); and the comorbidity indices ECOG-PS, ASA score, and ACE-27. The Kaplan-Meier method and Cox proportional hazards model were used for survival analysis and identifying independent risk factors. RESULTS: A total of 302 patients were analyzed, 175 received concurrent chemotherapy. Median follow-up was 61.8 months, and median age at diagnosis was 61 years. The 3‑ and 5‑year overall survival (OS) and disease-free survival (DFS) rates were 70.5%/60.2% and 64.7%/57.6%, respectively. Both ACE-27 and ASA showed significant correlations with OS in univariate and multivariate analyses, while ECOG-PS was significant only in univariate analysis. ASA and ACE-27 scores were also significantly correlated with local and locoregional recurrence, but only HPV status and tumor stage were significant in multivariate models. CONCLUSION: ACE-27 and ASA score effectively categorize patients' risks in adjuvant radiotherapy for head and neck cancer, proving more predictive of overall survival than ECOG-PS. These results underscore the importance of objective comorbidity assessment and suggest further prospective studies.
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Publication type Article: Journal article
Document type Scientific Article
Keywords Adult Comorbidity Evaluation-27 (ace-27) ; American Society Of Anaesthesiologists-score (asa-score) ; Comorbidities ; Ecog-performance Status ; Head And Neck Cancer; Ecog Performance Status; Human-papillomavirus; Survival; Cohort; Impact; Evaluation-27; Morbidity; Prognosis; Mortality; Ace-27
Language english
Publication Year 2024
HGF-reported in Year 2024
ISSN (print) / ISBN 0179-7158
e-ISSN 1439-099X
Journal Strahlentherapie und Onkologie : Journal of Radiation Oncology, Biology, Physics
Publisher Urban & Vogel
Publishing Place Tiergartenstrasse 17, D-69121 Heidelberg, Germany
Reviewing status Peer reviewed
Institute(s) Translational Metabolic Oncology (IDC-TMO)
POF-Topic(s) 30504 - Mechanisms of Genetic and Environmental Influences on Health and Disease
30203 - Molecular Targets and Therapies
Research field(s) Radiation Sciences
PSP Element(s) G-521800-001
G-501000-001
Grants Klinikum der Universitt Mnchen (6933)
DOI 10.1007/s00066-024-02282-y
WOS ID 001302957000001
Scopus ID 85202962657
PubMed ID 39222095
Erfassungsdatum 2024-10-14
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