Definitive radiation with concurrent cetuximab vs. radiation with or without concurrent cytotoxic chemotherapy in older patients with squamous cell carcinoma of the head and neck: Analysis of the SEER-medicare linked database

•CTX-RT was associated with a significantly worse OS compared to CRT.•CTX-RT was associated with a similar OS compared to RT alone.•CTX-RT was independently associated with worse OS vs. CRT in multivariable analysis.•There was no difference in select toxicities between CTX-RT and CRT. To evaluate OS and toxicity after definitive radiation with concurrent cetuximab (CTX-RT) compared to radiation with concurrent cytotoxic chemotherapy (CRT) in older HNSCC patients via the SEER-Medicare linked database. We used the SEER-Medicare linked database to evaluate OS in HNSCC patients (Oropharynx, Larynx, Hypopharynx, Nasopharynx) diagnosed over 2005–2011, following FDA approval of cetuximab in combination with radiation therapy (RT) in March 2006. 2135 beneficiaries were identified. Median age was 73 (66–104) years. Primary was oropharynx (61%), hypopharynx (15%), nasopharynx (5%), and larynx (19%). CRT was platinum based in 82% of patients. CTX-RT was associated with worse OS compared to CRT (P