Hypofractionated Radiotherapy for HNSCC in Elderly Patients

Inclusion Criteria: 1. Age ≥ 65 years; 2. Patients with histologically or cytologically confirmed stage II-IVA head and neck squamous cell carcinoma (AJCC 8th edition), including oral cavity, oropharynx, hypopharynx, larynx, and cervical metastatic squamous carcinoma of unknown primary; 3. At least one measurable lesion; 4. No prior systemic antitumor treatment or locoregional therapy for head and neck squamous cell carcinoma; 5. ECOG performance status of 1-3; 6. Expected survival time of ≥ 3 months; 7. Patients assessed by the physician as unsuitable for surgical treatment and not candidates for radical radiotherapy; 8. Functional status of vital organs compatible with daily basic activities (excluding any blood components or cell growth factors within 14 days): adequate bone marrow reserve function: white blood cells (WBC) ≥ 2.0 × 10\^9/L, neutrophil count (NEUT) ≥ 1.0 × 10\^9/L, platelet count (PLT) ≥ 80 × 10\^9/L, hemoglobin (Hb) ≥ 90 g/L; 9. Able and willing to comply with the study and follow-up procedures; 10. The subject voluntarily agrees to participate in this clinical study and signs the informed consent form, demonstrating good compliance and ability to cooperate with follow-up. Exclusion Criteria: 1. Previously undergone radiotherapy for head and neck cancer; 2. Squamous cell carcinoma of other primary sites in the head and neck, such as paranasal sinuses, nasopharynx, glottic laryngeal cancer, skin, or salivary gland tissues; 3. Concurrent other antitumor therapies; 4. Neoadjuvant therapy; 5. Subjects who have experienced a severe infection within one month before enrollment, including but not limited to infections requiring hospitalization, bacteremia, severe pneumonia, etc.; 6. Subjects with any active infection or unexplained fever \> 38.5°C occurring during the screening period or before the first dose; 7. Presence of severe cardiovascular diseases: Grade II or higher myocardial ischemia or myocardial infarction, poorly controlled arrhythmias (including QTc interval male ≥ 450 ms, female ≥ 470 ms); NYHA Class III-IV heart failure (according to the New York Heart Association classification, see Appendix 3), or echocardiogram indicating left ventricular ejection fraction (LVEF) \< 50%; 8. History of other malignancies within the past five years (except for completely treated in situ cervical cancer or basal cell carcinoma or squamous cell carcinoma of the skin); 9. History of substance abuse involving psychiatric drugs that cannot be discontinued or presence of mental disorders.