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Treatment of head and neck cancer in the elderly

European Consensus (panel 6) at the EUFOS Congress in Vienna 2007

  • Head and Neck
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Abstract

The population in developed countries is growing older, with the number of people over 85 years of age increasing especially rapidly. The incidence of a head and neck cancer increases with age, only a few patients are under 40 years of age and the highest incidence in many sites occurs in patients over 70 years of age. The aging population has increasing amounts of comorbidities. The treatment protocols for head and neck cancer have over the last two decades become intensified as a consequence of larger surgical resections with reconstruction, high dose radiotherapy often in combination with chemotherapy or targeted therapeutic drugs. Should the elderly and old patients be treated similarly to the younger counterparts or should the treatment be altered based on chronologic age? During the EUFOS Congress in Oto-Rhino-Laryngology Head and Neck Surgery in Vienna, Austria 2007, a panel addressed this issue and this is a summary of the conclusions.

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References

  1. Finnish Cancer Registry. http://www.cancerregistry.fi

  2. Metges JP, Eschwege F, de Crevoisier R, Lusinchi A, Bourhis J, Wibault P (2000) Radiotherapy in head and neck cancer in the elderly: a challenge. Crit Rev Oncol Hematol 34:195–203

    Article  CAS  PubMed  Google Scholar 

  3. Kennedy BJ (1988) Aging and cancer. J Clin Oncol 6–12:1903–1911

    Google Scholar 

  4. Hirano M, Mori K (1998) Management of cancer in the elderly: therapeutic dilemmas. Otolaryngol Head Neck Surg 118:110–114

    Article  CAS  PubMed  Google Scholar 

  5. Sarini J, Fournier C, Lefebre JL, Bonafos G, Van JT, Coche-Dequeant B (2001) Head and neck squamous cell carcinoma in elderly patients: a long term retrospective review of 273 cases. Arch Otolaryngol Head Neck Surg 127:1089–1092

    CAS  PubMed  Google Scholar 

  6. Derks W, de Leeuw JR, Hordijk GJ, Winnubst JA (2005) Reasons for non-standard treatment in elderly patients with advanced head and neck cancer. Eur Arch Otorhinolaryngol 262:21–26

    Article  CAS  PubMed  Google Scholar 

  7. Bernardi D, Barzan L, Franchin G, Cinelli R, Balestreri L, Tirelli U, Vaccher E (2005) Treatment of head and neck cancer in elderly patients: state of the art and guidelines. Crit Rev Oncol Hematol 53:71–80

    Article  PubMed  Google Scholar 

  8. Clayman GL, Eicher SA, Sicard MW, Razmpa E, Goepfert H (1998) Surgical outcomes in head and neck cancer patients 80 years of age and older. Head Neck 20:216–223

    Article  CAS  PubMed  Google Scholar 

  9. Serletti JM, Higgins JP, Moran S, Orlando GS (2000) Factors affecting outcome in free-tissue transfer in the elderly. Plast Reconstr Surg 106(1):66–70

    Article  CAS  PubMed  Google Scholar 

  10. Derks W, de Leeuw JR, Hordijk GJ (2003) Elderly patients with head and neck cancer: short-term effects of surgical treatment on quality of life. Clin Otolaryngol 28:399–405

    Article  CAS  PubMed  Google Scholar 

  11. Beusang ES, Ang EE, Lipa JE et al (2003) Microvascular free tissue transfer in elderly patients: the Toronto experience. Head Neck 25:549–553

    Article  Google Scholar 

  12. Van der Schroeff MP, Derks W, Hordijk GJ, de Leeuw RJ (2007) The effect of age on survival and quality of life in elderly head and neck cancer patients: a long-term prospective study. Eur Arch Otorhinolaryngol 264:415–422

    Article  PubMed  Google Scholar 

  13. Pignon T, Horiot JC, Van den Bogaert W, Van Glabbeke M, Scalliet P (1996) No age limit for radical radiotherapy in head and neck tumours. Eur J Cancer 32A(12):2075–2081

    Article  CAS  PubMed  Google Scholar 

  14. Fu KK, Pajak TF, Trotti A, Jones CU, Spencer SA, Phillips TL, Garden AS, Ridge JA, Cooper JS, Anf KK (2000) A radiation therapy oncology group (RTOG) phase III randomized study to compare hyperfractionation and two variants of accelerated fractionation to standard fractionation radiotherapy for head and neck squamous cell carcinomas: first report of RTOG 9003. Int J Radiat Oncol Biol Phys 48(1):7–16

    Article  CAS  PubMed  Google Scholar 

  15. Skladowski K, Maciejewski B, Golen M, Pilecki B, Przeorek W, Tarnawski R (2000) Randomized clinical trial on 7-day-continuous accelerated irradiation (CAIR) of head and neck cancer: report on 3-year tumour control and normal tissue toxicity. Radiother Oncol 55(2):101–110

    Article  CAS  PubMed  Google Scholar 

  16. Trotti A (2000) Toxicity in head and neck cancer: a review of trends and issues. Int J Radiat Oncol Biol Phys 47(1):1–12

    CAS  PubMed  Google Scholar 

  17. Bonner JA, Harari PM, Giralt J, Azarnia N, Shin DM, Cohen RB, Jones CU, Sur R, Raben D, Jassem J, Ove R, Kies MS, Baselga J, Youssoufian H, Amellal N, Rowinsky EK, Ang KK (2006) Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and neck. N Engl J Med 354(6):567–578

    Article  CAS  PubMed  Google Scholar 

  18. Bourhis J, Overgaard J, Audry H, Ang KK, Saunders M, Bernier J, Horiot JC, Le Maître A, Pajak TF, Poulsen MG, O’Sulllivan B, Dobrowsky W, Hliniak A, Skladowski K, Hay JH, Pinto LH, Fallai C, Fu KK, Sylvester R, Pignon JP, Meta-analysis of radiotherapy in carcinomas of head, neck (MARCH) collaborative group (2006) Hyperfractionated or accelerated radiotherapy in head and neck cancer: a meta-analysis. Lancet 368(9538):843–854

    Article  PubMed  Google Scholar 

  19. Wedding U, Honecker F, Bokemeyer C, Pientka L, Höffken K (2007) Tolerance to chemotherapy in elderly patients with cancer. Cancer Control 14(1):44–56

    PubMed  Google Scholar 

  20. Genden EM, Rinaldo A, Shaha AR, Clayman GL, Werner JA, Suárez C, Ferlito A (2005) Treatment considerations for head and neck cancer in the elderly. J Laryngol Otol 119(3):169–174

    Article  PubMed  Google Scholar 

  21. Sanabria A, Carvalho AL, Vartanian JG, Magrin J, Ikeda MK, Kowalski LP (2007) Factors that influence treatment decision in older patients with resectable head and neck cancer. Laryngoscope 117(5):835–840

    Article  PubMed  Google Scholar 

  22. Shestak KC, Jones NF, Wu W, Johnson JT, Myers EN (1992) Effect of advanced age and medical disease on the outcome of microvascular reconstruction for head and neck defects. Head Neck 14(1):14–18

    Article  CAS  PubMed  Google Scholar 

  23. Piccirillo JF (2000) Importance of comorbidity in head, neck cancer. Laryngoscope 110(4):593–602

    Article  CAS  PubMed  Google Scholar 

  24. Derks W, de Leeuw RJ, Hordijk GJ, Winnubst JA (2004) Quality of life in elderly patients with head and neck cancer one year after diagnosis. Head Neck 26(12):1045–1052

    Article  PubMed  Google Scholar 

  25. Rogers SN, Miller RD, Ali K, Minhas AB, Williams HF, Lowe D (2006) Patients perceived health status following primary surgery for oral and oropharyngeal cancer. Int J Oral Maxillofac Surg 35(10):913–919

    Article  CAS  PubMed  Google Scholar 

  26. Derks W, de Leeuw JR, Hordijk GJ, Winnubst JA (2005) Differences in coping style and locus of control between older and younger patients with head and neck cancer. Clin Otolaryngol 30(2):186–192

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Otorhinolaryngology-Head and Neck Surgery, University of Turku and Turku University Hospital, P.O. Box 52, 20521, Turku, Finland

    Reidar Grénman

  2. Department of Otorhinolaryngology-Head and Neck Surgery, The Lille University, Lille, France

    Dominique Chevalier

  3. Department of Radiation Oncology, Université catholique de Louvain, St-Luc University Hospital, Brussels, Belgium

    Vincent Gregoire

  4. Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Eugene Myers

  5. Department of Oral and Maxillofacial Surgery, University Hospital Aintree, Liverpool, UK

    Simon Rogers

Authors
  1. Reidar Grénman
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  2. Dominique Chevalier
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  3. Vincent Gregoire
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  4. Eugene Myers
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  5. Simon Rogers
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Correspondence to Reidar Grénman.

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Grénman, R., Chevalier, D., Gregoire, V. et al. Treatment of head and neck cancer in the elderly. Eur Arch Otorhinolaryngol 267, 1619–1621 (2010). https://doi.org/10.1007/s00405-010-1263-6

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  • DOI: https://doi.org/10.1007/s00405-010-1263-6

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