Large number of Medicare patients with head and neck cancers unlikely to complete radiation therapy

Medicare patients aged 66 years and older with head and neck cancers, particularly those who did not undergo surgery, were not likely to complete radiotherapy, according to recently published data.

Researchers examined data from 5,086 patients from the SEER–Medicare linked database to investigate the association between tumors and clinical characteristics and interruption or discontinuation of therapy.

Overall, 39.8% of patients had interruptions or incomplete therapy; 70.4% of patients who had surgery completed radiation therapy without interruptions compared with 52.0% of patients who did not have surgery (P<.001).

The researchers noted various reasons for why patients who receive surgery may be more likely to continue treatment.

“First, characteristics that make patients good candidates for surgery may also make them more likely to complete radiotherapy … In addition, patients who are willing to undergo major surgery to treat their disease may also be more motivated to complete a full course of uninterrupted radiation therapy, despite any toxic effects of treatment that may occur,” they wrote.

Conversely, patients with oral, pharyngeal and laryngeal tumors who received chemotherapy concurrently with radiotherapy were more likely to discontinue or interrupt treatment with radiation.

“This association could be attributed to the toxic effects of the chemotherapeutic agents commonly administered for head and neck cancers,” the researchers wrote.

Further research is needed to identify factors associated with discontinuation and/or interruption of radiotherapy among these patients and to identify chemotherapy agents, doses and schedules that may reduce the chances of treatment completion, according to researchers.

Fesinmeyer MD. Arch Otolaryngol Head Neck Surg. 2009;135:860-867.