患有头颈鳞状细胞癌（HNSCC）的老年人数量正在增加，这些患者的治疗具有挑战性。尽管基于顺铂的化疗联合放疗被认为是局部晚期 HNSCC 患者的标准治疗方案，但老年 HNSCC 患者的联合化疗存在很大的现实异质性。 XXX 研究是一项国际多中心队列研究，包括年龄较大（≥65 岁）的患者HNSCC 患者在美国和欧洲的 13 个学术中心接受了根治性放射治疗。在这里，使用 Kaplan-Meier 分析对同时放化疗的患者的总生存期 (OS) 和无进展生存期 (PFS) 进行分析，同时对局部区域失败 (LRF) 和远处转移的发生率进行 Fine-Gray 竞争风险回归。 DM）。本次分析纳入了 697 名中位年龄为 71 岁的患者。单药顺铂是最常见的化疗方案 (n=310; 44%)，其次是顺铂加 5-氟尿嘧啶 (n=137; 20%)、卡铂 (n=73; 10%) 和丝裂霉素 c 加 5 -氟尿嘧啶（n=64；9%）。与单药顺铂相比，基于卡铂的治疗方案与 PFS 降低（HR=1.39 [1.03-1.89]，p<0.05）和 LRF 发生率较高（SHR=1.54 [1.00-2.38]，p=.05）相关。 ，而 OS（HR=1.15 [0.80-1.65]，p=.46）具有可比性。单药和多药顺铂方案之间没有肿瘤学差异（全部 p>.05）。顺铂的中位累积剂量为 180 mg/m2（IQR，120-200 mg/m2）。顺铂累积剂量≥200 mg/m2 与 OS (HR=0.71 [0.53-0.95], p=.02)、PFS (HR=0.66 [0.51-0.87], p=.003) 增加以及较低的发生率相关。 LRF（SHR=0.50 [0.31-0.80]，p=.004）。在 OS 多变量回归分析中，较高的累积顺铂剂量仍然是一个独立的预后变量（HR=0.996 [0.993-0.999]，p=.009）。 单药顺铂可被视为老年 HNSCC 患者的标准化疗方案，这些患者可以耐受顺铂。顺铂累积剂量对于老年 HNSCC 患者也具有预后相关性。XXX.版权所有 © 2023。由 Elsevier Inc. 出版。

The number of older adults with head-and-neck squamous cell carcinoma (HNSCC) is increasing, and treatment of these patients is challenging. Although cisplatin-based chemotherapy concomitantly with radiotherapy is considered standard regimen for patients with locoregionally advanced HNSCC, there is substantial real-world heterogeneity regarding concomitant chemotherapy in older HNSCC patients.The XXX study is an international multicenter cohort study including older (≥65 years) HNSCC patients treated with definitive radiotherapy at 13 academic centers in the United States and Europe. Here, patients with concomitant chemoradiation were analyzed regarding overall survival (OS) and progression-free survival (PFS) using Kaplan-Meier analyses, while Fine-Gray competing risks regressions were performed regarding the incidence of locoregional failures (LRFs) and distant metastases (DMs).Six hundred ninety-seven patients with a median age of 71 years were included in this analysis. Single-agent cisplatin was the most common chemotherapy regimen (n=310; 44%), followed by cisplatin plus 5-fluorouracil (n=137; 20%), carboplatin (n=73; 10%), and mitomycin c plus 5-fluorouracil (n=64; 9%). Carboplatin-based regimens were associated with diminished PFS (HR=1.39 [1.03-1.89], p<0.05) and a higher incidence of LRFs (SHR=1.54 [1.00-2.38], p=.05) compared with single-agent cisplatin, whereas OS (HR=1.15 [0.80-1.65], p=.46) was comparable. There were no oncological differences between single-agent and multi-agent cisplatin regimens (all p>.05). Median cumulative dose of cisplatin was 180 mg/m2 (IQR, 120-200 mg/m2). Cumulative cisplatin doses ≥200 mg/m2 were associated with increased OS (HR=0.71 [0.53-0.95], p=.02), PFS (HR=0.66 [0.51-0.87], p=.003), and lower incidence of LRFs (SHR=0.50 [0.31-0.80], p=.004). Higher cumulative cisplatin doses remained an independent prognostic variable in the multivariate regression analysis for OS (HR=0.996 [0.993-0.999], p=.009).Single-agent cisplatin can be considered as the standard chemotherapy regimen for older HNSCC patients who can tolerate cisplatin. Cumulative cisplatin doses are prognostically relevant also in older HNSCC patients.XXX.Copyright © 2023. Published by Elsevier Inc.