Therapeutic Patterns and Outcomes of Clinically Non-surgically Managed Stage III-IVB Laryngeal Cancer in Patients Aged ≥65 years

Objectives This retrospective study aimed to investigate therapeutic patterns and survival outcomes among elderly patients with stage III-IVB clinically non-surgically managed locally advanced laryngeal cancer treated with radiotherapy (RT) alone or RT plus concurrent chemotherapy (CT). Methods A retrospective analysis was conducted using data from the Surveillance, Epidemiology, and End Results (SEER) database. Atotal of 882 patients aged ≥65 years with stage III-IVB clinically non-surgically managed laryngeal squamous cell cancer (LSCC) diagnosed between 2010 and 2015 were identified. Kaplan-Meier survival analysis and log-rank tests were performed to compare outcomes between patients receiving RT alone (n=220) and those receiving RT plus CT (n=662). Results The estimated 3-year overall survival (OS) and cancer-specific survival (CSS) rates were 50% and 58.7%, respectively. Univariate analyses identified age, clinical stage, N stage, and treatment modality as significant predictors of OS and CSS. Multivariate analyses demonstrated that treatment modality and age were independently associated with OS, whereas treatment modality, N stage, age, and T stage were independent predictors of CSS. Subgroup analyses revealed that patients with T3 or N2 disease achieved superior OS and CSS after treatment with RT plus CT. Conclusion RT plus CT was associated with improved survival outcomes in elderly LSCC patients with clinically non-surgically managed LSCC. Furthermore, this combination therapy provided significant survival benefits, particularly among patients with T3 or N2 disease.