{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T23:10:13Z","timestamp":1784157013787,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,3,30]],"date-time":"2018-03-30T00:00:00Z","timestamp":1522368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Older patients are at increased risk of toxicities from aggressive oncologic therapy and of nononcologic death. A meta\u2010analysis of non\u2010nasopharyngeal head and neck cancers showed no statistical benefit in adding chemotherapy to radiotherapy (<jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content>) in older patients; another meta\u2010analysis of <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> versus chemoradiotherapy (<jats:styled-content style=\"fixed-case\">CRT<\/jats:styled-content>) in <jats:styled-content style=\"fixed-case\">NPC<\/jats:styled-content> found advantages to <jats:styled-content style=\"fixed-case\">CRT<\/jats:styled-content>, but vastly under\u2010represented patients \u226570\u00a0years old. This is the largest study to date evaluating outcomes of <jats:styled-content style=\"fixed-case\">CRT<\/jats:styled-content> versus <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> alone in this population. The National Cancer Data Base (<jats:styled-content style=\"fixed-case\">NCDB<\/jats:styled-content>) was queried for primary nasopharyngeal cancer cases (2004\u20132013) in patients \u226570\u00a0years old receiving <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> alone or <jats:styled-content style=\"fixed-case\">CRT<\/jats:styled-content>. Patients with unknown <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content>\/chemotherapy and T1N0 or M1 disease were excluded. Logistic regression analysis ascertained factors associated with <jats:styled-content style=\"fixed-case\">CRT<\/jats:styled-content> delivery. Kaplan\u2013Meier analysis evaluated overall survival (<jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content>) between both cohorts. Cox proportional hazards modeling determined variables associated with <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content>. In total, 930 patients were analyzed (<jats:italic>n<\/jats:italic>\u00a0=\u00a0713 (77%) <jats:styled-content style=\"fixed-case\">CRT<\/jats:styled-content>,<jats:italic> n<\/jats:italic>\u00a0=\u00a0217 (23%) <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content>). Groups were relatively balanced; <jats:styled-content style=\"fixed-case\">CRT<\/jats:styled-content> was less frequently delivered in patients with advancing age, lower nodal burden, and females (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05 for all). Median <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> in the <jats:styled-content style=\"fixed-case\">CRT<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> groups were 35.3 versus 20.0\u00a0months, respectively (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.002). On multivariate analysis, independent predictors of <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> included age, comorbidities, income and insurance status, tumor grade, and stage (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05 for all). Notably, receipt of chemotherapy independently predicted for improved <jats:styled-content style=\"fixed-case\">OS<\/jats:styled-content> (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.036). <jats:styled-content style=\"fixed-case\">CRT<\/jats:styled-content>, compared to <jats:styled-content style=\"fixed-case\">RT<\/jats:styled-content> alone, was independently associated with improved survival in <jats:styled-content style=\"fixed-case\">NPC<\/jats:styled-content> patients \u226570\u00a0years old. <jats:styled-content style=\"fixed-case\">CRT<\/jats:styled-content> appears to be a promising approach in this population, but treatment\u2010related toxicity risks should continue to be weighed against potential oncologic benefits.<\/jats:p>","DOI":"10.1002\/cam4.1290","type":"journal-article","created":{"date-parts":[[2018,3,31]],"date-time":"2018-03-31T05:10:28Z","timestamp":1522473028000},"page":"1604-1611","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Practice patterns and outcomes of chemoradiotherapy versus radiotherapy alone for older patients with nasopharyngeal cancer"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5863-6023","authenticated-orcid":false,"given":"Vivek","family":"Verma","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology University of Nebraska Medical Center  Omaha Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swati M.","family":"Surkar","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy Washington University School of Medicine  St. Louis Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy C.","family":"Moreno","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Nebraska Medical Center  Omaha Nebraska"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"II","given":"Charles B.","family":"Simone","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Maryland Medical Center  Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,3,30]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2009.04.014"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2016.01.010"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semradonc.2012.05.009"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.2012-0427"},{"key":"e_1_2_7_6_1","unstructured":"National Comprehensive Cancer Network. 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