Radiotherapy outcomes and risk factors for young patients with head-and-neck squamous cell carcinomas: a matched-pair analysis

Abstract Background Head-and-neck squamous cell carcinomas (HNSCC) exhibit significant variations in incidence and outcomes across age groups. There is conflicting data on the oncological outcomes of younger HNSCC patients ≤ 45 years. This study analyzed clinical characteristics, treatment-related t...

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Main Authors: Jiadai Zou, Alexander Rühle, Henning Schäfer, Andreas Dietz, Gunnar Wichmann, Thomas Kuhnt, Anca-L. Grosu, Nils H. Nicolay
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Radiation Oncology
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Online Access:https://doi.org/10.1186/s13014-025-02631-w
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author Jiadai Zou
Alexander Rühle
Henning Schäfer
Andreas Dietz
Gunnar Wichmann
Thomas Kuhnt
Anca-L. Grosu
Nils H. Nicolay
author_facet Jiadai Zou
Alexander Rühle
Henning Schäfer
Andreas Dietz
Gunnar Wichmann
Thomas Kuhnt
Anca-L. Grosu
Nils H. Nicolay
author_sort Jiadai Zou
collection DOAJ
description Abstract Background Head-and-neck squamous cell carcinomas (HNSCC) exhibit significant variations in incidence and outcomes across age groups. There is conflicting data on the oncological outcomes of younger HNSCC patients ≤ 45 years. This study analyzed clinical characteristics, treatment-related toxicities and survival rates of young HNSCC patients treated with (chemo)radiotherapy. Methods HNSCC patients ≤ 45 years treated with radiotherapy between 2009 and 2021 at two large cancer centers were analyzed and matched to a patient cohort > 45 years based on TNM and tumor localization. Overall (OS), progression-free (PFS) and metastasis-free (DMFS) survival and locoregional control (LRC) were compared and treatment-related toxicities were assessed. Results 99 patients were included in this analysis. Median OS of the young HNSCC cohort was 63 months. Daily alcohol consumption was identified as a key risk factor for reduced OS in the multivariate analysis. OS was similar in the young cohort compared to older patients, although the excess mortality risk compared to the sex- and age-matched general population amounted to 59-fold, while it was only 5.9-fold for patients ≥ 45 years. No significant differences were observed in PFS, LRC, or DMFS between age groups. Higher-grade chronic toxicities were moderate in young HNSCC patients. Conclusions Young HNSCC patients ≤ 45 years treated with (chemo)radiation have similar rates of oncological survival outcomes compared to older patients. While chronic toxicities from (chemo)radiation are low, further research is needed to explore the long-term quality-of-life.
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spelling doaj-art-b5bd28e5268042df930e0425a8b066792025-08-20T02:30:18ZengBMCRadiation Oncology1748-717X2025-04-0120111110.1186/s13014-025-02631-wRadiotherapy outcomes and risk factors for young patients with head-and-neck squamous cell carcinomas: a matched-pair analysisJiadai Zou0Alexander Rühle1Henning Schäfer2Andreas Dietz3Gunnar Wichmann4Thomas Kuhnt5Anca-L. Grosu6Nils H. Nicolay7Department of Radiation Oncology, University of Leipzig Medical CenterDepartment of Radiation Oncology, University of Leipzig Medical CenterDepartment of Radiation Oncology, University Medical Center FreiburgComprehensive Cancer Center Central Germany, Partner Site LeipzigComprehensive Cancer Center Central Germany, Partner Site LeipzigDepartment of Radiation Oncology, University of Leipzig Medical CenterDepartment of Radiation Oncology, University Medical Center FreiburgDepartment of Radiation Oncology, University of Leipzig Medical CenterAbstract Background Head-and-neck squamous cell carcinomas (HNSCC) exhibit significant variations in incidence and outcomes across age groups. There is conflicting data on the oncological outcomes of younger HNSCC patients ≤ 45 years. This study analyzed clinical characteristics, treatment-related toxicities and survival rates of young HNSCC patients treated with (chemo)radiotherapy. Methods HNSCC patients ≤ 45 years treated with radiotherapy between 2009 and 2021 at two large cancer centers were analyzed and matched to a patient cohort > 45 years based on TNM and tumor localization. Overall (OS), progression-free (PFS) and metastasis-free (DMFS) survival and locoregional control (LRC) were compared and treatment-related toxicities were assessed. Results 99 patients were included in this analysis. Median OS of the young HNSCC cohort was 63 months. Daily alcohol consumption was identified as a key risk factor for reduced OS in the multivariate analysis. OS was similar in the young cohort compared to older patients, although the excess mortality risk compared to the sex- and age-matched general population amounted to 59-fold, while it was only 5.9-fold for patients ≥ 45 years. No significant differences were observed in PFS, LRC, or DMFS between age groups. Higher-grade chronic toxicities were moderate in young HNSCC patients. Conclusions Young HNSCC patients ≤ 45 years treated with (chemo)radiation have similar rates of oncological survival outcomes compared to older patients. While chronic toxicities from (chemo)radiation are low, further research is needed to explore the long-term quality-of-life.https://doi.org/10.1186/s13014-025-02631-wRadiotherapyChemotherapyHNSCCHead-and-neck cancerYoung
spellingShingle Jiadai Zou
Alexander Rühle
Henning Schäfer
Andreas Dietz
Gunnar Wichmann
Thomas Kuhnt
Anca-L. Grosu
Nils H. Nicolay
Radiotherapy outcomes and risk factors for young patients with head-and-neck squamous cell carcinomas: a matched-pair analysis
Radiation Oncology
Radiotherapy
Chemotherapy
HNSCC
Head-and-neck cancer
Young
title Radiotherapy outcomes and risk factors for young patients with head-and-neck squamous cell carcinomas: a matched-pair analysis
title_full Radiotherapy outcomes and risk factors for young patients with head-and-neck squamous cell carcinomas: a matched-pair analysis
title_fullStr Radiotherapy outcomes and risk factors for young patients with head-and-neck squamous cell carcinomas: a matched-pair analysis
title_full_unstemmed Radiotherapy outcomes and risk factors for young patients with head-and-neck squamous cell carcinomas: a matched-pair analysis
title_short Radiotherapy outcomes and risk factors for young patients with head-and-neck squamous cell carcinomas: a matched-pair analysis
title_sort radiotherapy outcomes and risk factors for young patients with head and neck squamous cell carcinomas a matched pair analysis
topic Radiotherapy
Chemotherapy
HNSCC
Head-and-neck cancer
Young
url https://doi.org/10.1186/s13014-025-02631-w
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