3632 - Trajectory of Geriatric Assessment and Quality of Life in Older Adults Undergoing Definitive Treatment for Head and Neck Cancer: A Pilot Study

R. S. Davis¹, C. Sun², H. Kim², T. Abuali¹, C. J. Ladbury¹, J. Vazquez³, V. Katheria², V. Sun⁴, E. Maghami⁵, T. Gernon⁵, R. Kang⁵, S. Maroongroge¹, S. Sampath¹, V. Villaflor⁶, W. Dale², and A. Amini¹; ¹Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA, ²City of Hope National Medical Center, Duarte, CA, ³City of Hope Comprehensive Cancer Center, Duarte, CA, ⁴Division of Population Sciences, City of Hope National Medical Center, Duarte, CA, ⁵Department of Surgery, City of Hope National Medical Center, Duarte, CA, ⁶Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, CA

Purpose/Objective(s): Definitive treatment for head and neck (H&N) cancers is associated with marked toxicity. Older adults represent a population in which toxicity may be more pronounced. Data regarding impact of treatment on geriatric domains are lacking and could guide efforts of early supportive interventions. Materials/

Methods: This is a prospective, longitudinal, observational pilot study collecting comprehensive geriatric assessment (CGA), and quality of life (QoL) measures from older patients (=65 years) with non-metastatic H&N cancer treated with definitive concurrent chemoradiation (CRT) or upfront surgery (S) followed by adjuvant RT ± chemotherapy. Descriptive statistics (mean [SD]) were used to summarize CGA scores and domains and QoL measures. Using linear mixed models, the study examined change across three time points (baseline [BL], 1 month [mo] post-treatment, and 6 mo post-treatment).
Results: 13 patients (12 male) were enrolled. 4 patients underwent upfront surgery (all oral cavity cancer [3 stage II, 1 stage IVB]). 9 patients (2 oral cavity cancer [stage III], 4 oropharynx cancer [2 stage I and 2 stage III], 1 salivary gland [stage III], 1 nasopharynx [stage III], and 1 larynx [stage I]) received CRT. Significant declines in activities of daily living (ADL), instrumental ADL, mental health index (MHI), self-reported Karnofsky performance status (KPS), social activity and QoL were observed from BL to 1 mo post-adjuvant therapy, followed by recovery at 6 mo post-treatment for S patients. Patients undergoing CRT did not exhibit significant fluctuations in CGA or QoL measures. ^*1 month vs BL P <.05 ^~1 month vs 6 Month P <.05
Conclusion: Older H&N cancer patients undergoing upfront surgery but not CRT show a significant temporary decline in functional status, physical activity, and QoL, with recovery six mo post-treatment. These data highlight the need for CGA and tailored interventions to support recovery and QoL. Further research with a larger cohort is needed to confirm these findings and guide clinical practice. Abstract 3632 – Table 1

		BL	1 mo	6 mo
ADL	S CRT	82.5 (23.6) 81.1 (24.7)	46.3 (38.4)* 76.1 (28.7)	72.5 (26.0)~ 78.3 (24.9)
Self KPS	S CRT	87.5 (5.0) 90.0 (12.3)	62.5 (12.6)* 84.4 (15.1)	85.0 (10.0)~ 85.6 (11.3)
Social Activity	S CRT	60.4 (24.9) 46.3 (19.1)	18.8 (15.8)* 34.3 (27.8)	39.6 (36.2)~ 44.4 (22.8)
MHI	S CRT	72.6 (15.4) 80.5 (24.3)	59.7 (25.8) 72.7 (22.8)	75.6 (13.2) 74.9 (19.0)
FACT-H&N	S CRT	96.3(20.6) 109.4 (24.6)	75.5 (18.2) 101.5 (23.7)	91.0 (17.0) 102.4 (18.4)