Early (90-day) mortality after radical radiotherapy for head and neck squamous cell carcinoma: A population-based analysis

Head Neck. 2018 Nov;40(11):2432-2440. doi: 10.1002/hed.25352. Epub 2018 Oct 8.

Abstract

Background: A retrospective, population-based analysis of 90-day mortality in patients with squamous cell carcinoma of the head and neck treated with radiotherapy was performed to determine the early mortality rate and associated risk factors.

Methods: Data were abstracted for all consecutive patients with cancer of the head and neck treated from 1998 to 2014 at the BC Cancer Agency with curative intent radiotherapy (n = 5658). Logistic regression analysis was used to determine factors associated with early mortality.

Results: The median age at diagnosis was 63 years. The mortality rate at 90 days after starting radiotherapy (RT) was 3.6% (n = 203/5658). The cause of death was attributed to head and neck cancer for 81% of patients. Multivariate analysis demonstrated that increasing age, oral cavity subsite, and advanced T and N classification were associated with an increased risk of early mortality (p < .05).

Conclusions: The risk of early mortality was 3.6%. Elderly patients with advanced T and N classification had the highest risk of early mortality.

Keywords: early mortality; head and neck cancer; radiotherapy.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cause of Death*
  • Cohort Studies
  • Databases, Factual
  • Female
  • Head and Neck Neoplasms / mortality*
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / radiotherapy*
  • Humans
  • Kaplan-Meier Estimate
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prognosis
  • Radiotherapy Dosage
  • Radiotherapy, Conformal
  • Radiotherapy, Intensity-Modulated / methods
  • Retrospective Studies
  • Risk Assessment
  • Squamous Cell Carcinoma of Head and Neck / mortality*
  • Squamous Cell Carcinoma of Head and Neck / pathology
  • Squamous Cell Carcinoma of Head and Neck / radiotherapy*
  • Survival Analysis
  • Time Factors