Abstract
Despite the increasing number of elderly patients requiring treatment for head and neck cancer, there is insufficient available evidence about the oncological results of treatment and its tolerability in such patients. Owing to comorbidities, elderly patients often need complex evaluation and pretreatment management, which often results in their exclusion from clinical trials. The question of which patients constitute the highest-risk groups regarding treatment-related morbidity and mortality, and who can tolerate and benefit from aggressive treatment, has not been adequately studied. Biologic rather than chronologic age should be a more important factor in treatment protocols. Age-specific prospective clinical studies are needed on the treatment of head and neck cancer in elderly patients.
Zusammenfassung
Trotz zunehmender Häufigkeit der „älteren“ Patienten mit Karzinomen im Kopf-Hals-Bereich ist insgesamt wenig über die onkologischen Resultate und Verträglichkeit der Therapie bei diesen Patienten bekannt. In klinischen Studien stellt fortgeschrittenes Lebensalter oft ein Ausschlusskriterium dar, weil für ältere Patienten aufgrund ihrer Komorbiditäten häufig eine aufwendigere Untersuchung und prätherapeutische Versorgung benötigt werden. Die Fragen, welche Patienten das höchste Risiko bezüglich therapiebedingter Morbidität und Mortalität aufweisen und welche Patienten von einer aggressiven Therapie profitieren und diese vertragen, sind nicht adäquat untersucht worden. Für Therapieentscheidungen sollte eher das biologische Alter als das chronologische Alter Berücksichtigung finden. Altersspezifische prospektive klinische Studien zur Behandlung von Patienten mit einem Kopf-Hals-Karzinom im fortgeschrittenen Lebensalter sind erforderlich.
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A. Teymoortash, A. Ferlito, and G. B. Halmos state that there are no conflicts of interest.
The accompanying manuscript does not include studies on humans or animals.
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The authors of this article are members of the International Head and Neck Scientific Group (www.IHNSG.com).
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Teymoortash, A., Ferlito, A. & Halmos, G.B. Treatment in elderly patients with head and neck cancer. HNO 64, 217–220 (2016). https://doi.org/10.1007/s00106-016-0138-6
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DOI: https://doi.org/10.1007/s00106-016-0138-6