Hypofractionated Radiotherapy in Elderly Patients With Head & Neck Squamous Cell Carcinoma

Prior treatment

• Previous or current malignancies at other sites, with the exception of adequately treated in situ carcinoma of the cervix, basal or squamous cell carcinoma of the skin, thyroid cancer, or other cancer curatively treated by surgery and with no current evidence of disease for at least 5 years.
• Prior RT of head and neck area
• Concurrent chemotherapy or immunotherapy or hormonotherapy

Other illness

• Metastatic disease outside of the head and neck
• Any comorbid connective tissue disorder which could aggravate RT associated toxicities (e.g. Scleroderma)
• In cases where patients cannot consent on their own due to underlying dementia, we can consent the patient's healthcare proxy

Other

• Patients \< 70
• Pregnancy

• Age ≥ 70 years.
• No previous RT or chemotherapy for HNSCC is allowed at time of study entry.
• Life expectancy \> 12 weeks.
• Participants must have histologically or cytologically confirmed diagnosis of HNSCC: oral cavity, oropharynx, nasopharynx, hypopharynx, larynx, cervical nodes (unknown primary)
• All stages (according to National Comprehensive Cancer Network 8th edition for head and neck cancers), except stage IVC5
• Non-concurrent chemotherapy
• First line treatment
• Anyone eligible for definitive or adjuvant based RT therapy
• Adjuvant therapy when histopathological factors (advanced T category, nodal disease, lymphovascular or perineural invasion, high-grade, or positive margins)
• Anyone being treated with curative intent
• Unfit as determined by the treating physician and ECOG performance 1, 2, or 3 (Appendix 2).
• Ability to understand and the willingness to sign a written informed consent.