{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:05:09Z","timestamp":1789052709896,"version":"build-2803163510"},"reference-count":54,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2022,12,14]],"date-time":"2022-12-14T00:00:00Z","timestamp":1670976000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background. The aim of this work was to analyze the interplay between age and viral status on the outcomes in loco-regionally advanced oropharyngeal and nasopharyngeal cancer patients treated with radiotherapy and different chemotherapy combinations. Methods. A retrospective (2006\u20132017) analysis was performed on non-metastatic loco-regionally advanced oropharyngeal (both HPV+ and HPV\u2212) and EBV+ nasopharyngeal cancer patients (young: &lt;65 years vs. elderly: \u226565 years) treated with radiotherapy with or without chemotherapy. The impact of age and viral status on overall (OS) and disease-free survival (DFS) were studied with multivariable models, which were adjusted for smoking, stage, comorbidities, chemotherapy dose intensity and treatment strategy. Results. We analyzed 324 patients (146 HPV+ oropharynx, 63 HPV\u2212, 115 nasopharynx). Elderly patients had more comorbidities, and received less intensive treatments when compared to younger subjects. Although OS and DFS were shorter in older patients, after adjustment for stage, smoking, comorbidities, treatment strategy and dose intensity, no significant differences in terms of survival were observed according to age (65 vs. 50 years of age: HR 1.89, 95% CI 0.45\u20137.84 for HPV+ OPC; HR 0.91, 95% CI 0.29\u20132.89 for HPV\u2212 OPC; HR 1.99, 95% CI 0.9\u20134.39 for NPC; p = 0.395). Conclusions. Several potential age-related (comorbidities, treatment intensity) and disease-related (stage) confounding factors play a prognostic role with differential impacts on both virus and non-virus-related tumors. In HPV+ oropharyngeal cancer and in EBV+ nasopharyngeal cancer patients, age should be considered as the expression of an array of host- and tumor-related features rather than an independent prognostic factor.<\/jats:p>","DOI":"10.3390\/cancers14246170","type":"journal-article","created":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T03:01:51Z","timestamp":1671073311000},"page":"6170","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The Interplay between Age and Viral Status in EBV-Related Nasopharyngeal and HPV-Related Oropharyngeal Carcinoma Patients"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1294-6859","authenticated-orcid":false,"given":"Stefano","family":"Cavalieri","sequence":"first","affiliation":[{"name":"Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy"},{"name":"Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Bossi","sequence":"additional","affiliation":[{"name":"Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7505-5784","authenticated-orcid":false,"given":"Gabriele","family":"Infante","sequence":"additional","affiliation":[{"name":"SSD Clinical Epidemiology and Trial Organization, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy"},{"name":"Department of Clinical Sciences and Community Health & Department of Economics, Management and Quantitative Methods, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalba","family":"Miceli","sequence":"additional","affiliation":[{"name":"SSD Clinical Epidemiology and Trial Organization, Department of Epidemiology and Data Science, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2556-9079","authenticated-orcid":false,"given":"Nicola Alessandro","family":"Iacovelli","sequence":"additional","affiliation":[{"name":"Radiotherapy Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eliana","family":"Ivaldi","sequence":"additional","affiliation":[{"name":"Radiotherapy Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura Deborah","family":"Locati","sequence":"additional","affiliation":[{"name":"Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiana","family":"Bergamini","sequence":"additional","affiliation":[{"name":"Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0188-9759","authenticated-orcid":false,"given":"Carlo","family":"Resteghini","sequence":"additional","affiliation":[{"name":"Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Imperia","family":"Nuzzolese","sequence":"additional","affiliation":[{"name":"Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Alfieri","sequence":"additional","affiliation":[{"name":"Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3132-844X","authenticated-orcid":false,"given":"Elena","family":"Colombo","sequence":"additional","affiliation":[{"name":"Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossana","family":"Ingargiola","sequence":"additional","affiliation":[{"name":"Radiotherapy Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marzia","family":"Franceschini","sequence":"additional","affiliation":[{"name":"Radiotherapy Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppina","family":"Calareso","sequence":"additional","affiliation":[{"name":"Radiology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Licitra","sequence":"additional","affiliation":[{"name":"Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy"},{"name":"Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ester","family":"Orlandi","sequence":"additional","affiliation":[{"name":"Radiotherapy Department, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"103116","DOI":"10.1016\/j.critrevonc.2020.103116","article-title":"Global prevalence of human papillomavirus-driven oropharyngeal squamous cell carcinoma following the ASCO guidelines: A systematic review and meta-analysis","volume":"156","author":"Mariz","year":"2020","journal-title":"Crit. Rev. Oncol. Hematol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1080\/00016489.2019.1669820","article-title":"Current status of human papillomavirus positivity in oropharyngeal squamous cell carcinoma in Europe: A systematic review","volume":"139","author":"Jensen","year":"2019","journal-title":"Acta Otolaryngol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1002\/cncr.32517","article-title":"Increasing incidence of Epstein-Barr virus\u2013related nasopharyngeal carcinoma in the United States","volume":"126","author":"Argirion","year":"2020","journal-title":"Cancer"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/j.annonc.2020.12.007","article-title":"Nasopharyngeal carcinoma: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up","volume":"32","author":"Bossi","year":"2021","journal-title":"Ann. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/S0140-6736(19)30956-0","article-title":"Nasopharyngeal carcinoma","volume":"394","author":"Chen","year":"2019","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"34","DOI":"10.4143\/crt.2017.551","article-title":"The characteristics and survival outcomes in patients aged 70 years and older with nasopharyngeal carcinoma in the intensity-modulated radiotherapy era","volume":"51","author":"Jin","year":"2019","journal-title":"Cancer Res. Treat."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e212907","DOI":"10.1001\/jamaoncol.2021.2907","article-title":"Projected Association of Human Papillomavirus Vaccination with Oropharynx Cancer Incidence in the US, 2020\u20132045","volume":"7","author":"Zhang","year":"2021","journal-title":"JAMA Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"104687","DOI":"10.1016\/j.oraloncology.2020.104687","article-title":"A new face of the HPV epidemic: Oropharyngeal cancer in the elderly","volume":"109","author":"Dickstein","year":"2020","journal-title":"Oral Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2993","DOI":"10.1002\/cncr.31385","article-title":"Increasing prevalence of human papillomavirus\u2013positive oropharyngeal cancers among older adults","volume":"124","author":"Windon","year":"2018","journal-title":"Cancer"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1016\/j.ijrobp.2016.11.044","article-title":"Exploring the Impact of Human Papillomavirus Status, Comorbidity, Polypharmacy, and Treatment Intensity on Outcome of Elderly Oropharyngeal Cancer Patients Treated with Radiation Therapy with or Without Chemotherapy","volume":"98","author":"Caparrotti","year":"2017","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"106132","DOI":"10.1016\/j.oraloncology.2022.106132","article-title":"Temporal trends in oropharyngeal cancer incidence, survival, and cancer-directed surgery among elderly Americans","volume":"134","author":"Chidambaram","year":"2022","journal-title":"Oral Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e274","DOI":"10.1016\/S1470-2045(17)30229-2","article-title":"Management of elderly patients with locoregionally confined head and neck cancer","volume":"18","author":"Porceddu","year":"2017","journal-title":"Lancet Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"103","DOI":"10.2217\/fon.12.166","article-title":"Critical analysis of locoregional failures following intensity-modulated radiotherapy for nasopharyngeal carcinoma","volume":"9","author":"Orlandi","year":"2013","journal-title":"Futur. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"518110","DOI":"10.3389\/fonc.2020.518110","article-title":"Role of IMRT\/VMAT-Based Dose and Volume Parameters in Predicting 5-Year Local Control and Survival in Nasopharyngeal Cancer Patients","volume":"10","author":"Iacovelli","year":"2020","journal-title":"Front. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.ejca.2016.08.013","article-title":"Impact of cisplatin dose intensity on human papillomavirus-related and -unrelated locally advanced head and neck squamous cell carcinoma","volume":"67","author":"Spreafico","year":"2016","journal-title":"Eur. J. Cancer"},{"key":"ref_16","unstructured":"NCCN (2021, January 15). Clinical Practice Guidelines in Oncology\u2014Head and Neck Cancers. Available online: https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/head-and-neck.pdf."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1832","DOI":"10.1093\/annonc\/mdr544","article-title":"Tumor stage, human papillomavirus and smoking status affect the survival of patients with oropharyngeal cancer: An Italian validation study","volume":"23","author":"Granata","year":"2012","journal-title":"Ann. Oncol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/S1470-2045(13)70011-1","article-title":"Induction chemotherapy followed by concurrent chemoradiotherapy (sequential chemoradiotherapy) versus concurrent chemoradiotherapy alone in locally advanced head and neck cancer (PARADIGM): A randomised phase 3 trial","volume":"14","author":"Haddad","year":"2013","journal-title":"Lancet Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2735","DOI":"10.1200\/JCO.2013.54.6309","article-title":"Phase III randomized trial of induction chemotherapy in patients with N2 or N3 locally advanced head and neck cancer","volume":"32","author":"Cohen","year":"2014","journal-title":"J. Clin. Oncol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1200\/JCO.2016.67.4119","article-title":"What is the best treatment of locally advanced nasopharyngeal carcinoma? An individual patient data network meta-analysis","volume":"35","author":"Marguet","year":"2017","journal-title":"J. Clin. Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1462","DOI":"10.1016\/j.annonc.2020.07.011","article-title":"Squamous cell carcinoma of the oral cavity, larynx, oropharynx and hypopharynx: EHNS\u2013ESMO\u2013ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up","volume":"31","author":"Machiels","year":"2020","journal-title":"Ann. Oncol."},{"key":"ref_22","unstructured":"H\u00e1jek, J., \u0160id\u00e1k, Z., and Sen, P. (1999). Theory of Rank Tests, Academic Press. [2nd ed.]."},{"key":"ref_23","unstructured":"Hollander, M., Wolfe, D.A., and Chicken, E. (1973). Nonparametric Statistical Methods, John Wiley & Sons. [3rd ed.]."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1093\/biomet\/38.1-2.141","article-title":"Note on an exact treatment of contingency, goodness of fit and other problems of significance","volume":"38","author":"Freeman","year":"1951","journal-title":"Biometrika"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/j.2517-6161.1995.tb02031.x","article-title":"Controlling the False Discovery Rate: A Practical and Powerful Approach to Multiple Testing","volume":"57","author":"Benjamini","year":"1995","journal-title":"J. R. Stat. Soc."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1002\/sim.4780080504","article-title":"Flexible regression models with cubic splines","volume":"8","author":"Durrleman","year":"1989","journal-title":"Stat. Med."},{"key":"ref_27","unstructured":"(2021, January 15). The R Project for Statistical Computing. Available online: https:\/\/www.r-project.org\/."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"4418","DOI":"10.3390\/ijerph10094418","article-title":"Patterns of smoking prevalence among the elderly in Europe","volume":"10","author":"Lugo","year":"2013","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1093\/gerona\/62.3.296","article-title":"Comorbidity in older adults: Nosology of impairment, diseases, and conditions","volume":"62","author":"Karlamangla","year":"2007","journal-title":"J. Gerontol. Ser. A Biol. Sci. Med. Sci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1093\/ageing\/afx136","article-title":"Does current smoking predict future frailty? The English longitudinal study of ageing","volume":"47","author":"Kojima","year":"2018","journal-title":"Age Ageing"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"3503","DOI":"10.1200\/JCO.2011.35.7301","article-title":"Population-based study of competing mortality in head and neck cancer","volume":"29","author":"Rose","year":"2011","journal-title":"J. Clin. Oncol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1200\/JCO.2008.20.9288","article-title":"Predictors of competing mortality in advanced head and neck cancer","volume":"28","author":"Mell","year":"2010","journal-title":"J. Clin. Oncol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1245\/s10434-014-3951-8","article-title":"Cancer-Specific Mortality and Competing Mortality in Patients with Head and Neck Squamous Cell Carcinoma: A Competing Risk Analysis","volume":"22","author":"Shen","year":"2015","journal-title":"Ann. Surg. Oncol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1111\/ecc.12179","article-title":"Serial comprehensive geriatric assessment in elderly head and neck cancer patients undergoing curative radiotherapy identifies evolution of multidimensional health problems and is indicative of quality of life","volume":"23","author":"Pottel","year":"2014","journal-title":"Eur. J. Cancer Care"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1093\/jnci\/92.9.709","article-title":"Evidence for a Causal Association between Human Papillomavirus and a Subset of Head and Neck Cancers","volume":"92","author":"Gillison","year":"2000","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_36","first-page":"3804","article-title":"HPV Positive Status Is a Favorable Prognostic Factor in Non-Nasopharyngeal Head and Neck Squamous Cell Carcinoma Patients: A Retrospective Study From the Surveillance, Epidemiology, and End Results Database","volume":"11","author":"Wu","year":"2021","journal-title":"Front. Oncol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1056\/NEJMoa0912217","article-title":"Human papillomavirus and survival of patients with oropharyngeal cancer","volume":"363","author":"Ang","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1038\/nrc.2018.11","article-title":"The molecular landscape of head and neck cancer","volume":"18","author":"Leemans","year":"2018","journal-title":"Nat. Rev. Cancer"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e2029882","DOI":"10.1001\/jamanetworkopen.2020.29882","article-title":"Development of a Nomogram Model for Treatment of Nonmetastatic Nasopharyngeal Carcinoma","volume":"3","author":"Zhang","year":"2020","journal-title":"JAMA Netw. Open"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"458","DOI":"10.14639\/0392-100X-1246","article-title":"Fattori prognostici del tumore testa-collo: Un\u2019analisi retrospettiva monocentrica di 10 anni","volume":"37","author":"Cadoni","year":"2017","journal-title":"Acta Otorhinolaryngol. Ital."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"568","DOI":"10.1634\/theoncologist.2012-0427","article-title":"Treatment of Older Patients with Head and Neck Cancer: A Review","volume":"18","author":"Fleming","year":"2013","journal-title":"Oncologist"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Xiao, G., Cao, Y., Qiu, X., Wang, W., and Wang, Y. (2013). Influence of gender and age on the survival of patients with nasopharyngeal carcinoma. BMC Cancer, 13.","DOI":"10.1186\/1471-2407-13-226"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1038\/bjc.2013.715","article-title":"Prognostic model for survival of local recurrent nasopharyngeal carcinoma with intensity-modulated radiotherapy","volume":"110","author":"Tian","year":"2014","journal-title":"Br. J. Cancer"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"66170","DOI":"10.18632\/oncotarget.10818","article-title":"Old age at diagnosis increases risk of tumor progression in nasopharyngeal cancer","volume":"7","author":"Xie","year":"2016","journal-title":"Oncotarget"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.1002\/hed.27084","article-title":"Additional parameters to improve the prognostic value of the 8th edition of the UICC classification for human papillomavirus-related oropharyngeal tumors","volume":"44","author":"Straetmans","year":"2022","journal-title":"Head Neck"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1200\/JCO.2014.58.6412","article-title":"Refining American joint committee on cancer\/union for international cancer control TNM stage and prognostic groups for human papillomavirus-related oropharyngeal carcinomas","volume":"33","author":"Huang","year":"2015","journal-title":"J. Clin. Oncol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1016\/S0140-6736(15)00055-0","article-title":"Nasopharyngeal carcinoma","volume":"387","author":"Chua","year":"2016","journal-title":"Lancet"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Zhang, L.-N., Qiu, X.-S., OuYang, P.-Y., Xiao, Y., Lan, X.-W., Deng, W., Xie, F.-Y., Wang, X.-C., Zhang, L.-N., and Qiu, X.-S. (2016). Age at diagnosis indicated poor prognosis in locoregionally advanced nasopharyngeal carcinoma. Oncotarget, 5.","DOI":"10.18632\/oncotarget.12544"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1177\/1945892420964054","article-title":"Salvage Endoscopic Nasopharyngectomy in Recurrent Nasopharyngeal Carcinoma: Prognostic Factors and Treatment Outcomes","volume":"35","author":"Li","year":"2021","journal-title":"Am. J. Rhinol. Allergy"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"5173","DOI":"10.1002\/cncr.33197","article-title":"Clinical outcomes of carbon-ion radiotherapy for patients with locoregionally recurrent nasopharyngeal carcinoma","volume":"126","author":"Hu","year":"2020","journal-title":"Cancer"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1001\/jamaoncol.2020.6736","article-title":"Screening Tools for Identifying Older Adults with Cancer Who May Benefit from a Geriatric Assessment","volume":"7","author":"Garcia","year":"2021","journal-title":"JAMA Oncol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1998","DOI":"10.1002\/cncr.21422","article-title":"Developing a cancer-specific geriatric assessment: A feasibility study","volume":"104","author":"Hurria","year":"2005","journal-title":"Cancer"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/j.oraloncology.2015.02.097","article-title":"Predictive factors of survival and treatment tolerance in older patients treated with chemotherapy and radiotherapy for locally advanced head and neck cancer","volume":"51","author":"Bahig","year":"2015","journal-title":"Oral Oncol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"5614","DOI":"10.7150\/jca.35311","article-title":"The impact of adult comorbidity evaluation-27 on the clinical outcome of elderly nasopharyngeal carcinoma patients treated with chemoradiotherapy or radiotherapy: A matched cohort analysis","volume":"10","author":"Wen","year":"2019","journal-title":"J. Cancer"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/14\/24\/6170\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:41:12Z","timestamp":1760146872000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/14\/24\/6170"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,14]]},"references-count":54,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["cancers14246170"],"URL":"https:\/\/doi.org\/10.3390\/cancers14246170","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,14]]}}}