Sesterhenn A M
Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Giessen und Marburg, Standort Marburg, Deutschhausstrasse 3, 35037 Marburg.
Laryngorhinootologie. 2007 Feb;86(2):95-100. doi: 10.1055/s-2006-945167. Epub 2007 Jan 11.
In the years to come health care systems of western industrialized nations are going to be increasingly faced with the results of demographic changes. Especially the part of elderly citizens will grow steadily. Thus, also an increasing number of malignant diseases not only in the head & neck area is expected. Decision-making in cancer therapy for elderly patients is challenging for medical professional since this subject is accompanied by a high rate of uncertainness. For fear of aggressive therapy regimens with subsequent increase of morbidity, in many cases only incomplete diagnostic and therapeutic measures are taken. Reviewing the literature there is almost complete international consensus, that patients suffering from squamous cell cancer of the head & neck should be treated with curative intention, if thorough preoperative assessment of present comorbidities is performed. Furthermore aggressive treatment options should not be excluded. An optimal medical adjustment of relevant concomitant diseases clearly improves the starting point. In comparison to younger control groups therapy associated complications do not occur significantly higher. For this reason elderly patients should be treated with curative intention. Age itself should never be a sole factor deciding which curative therapy should be undertaken. Exceptions could be made in patients with severe general comorbidity.
在未来几年,西方工业化国家的医疗保健系统将越来越多地面临人口结构变化的结果。特别是老年公民的比例将稳步增长。因此,预计不仅头颈部区域的恶性疾病数量也会增加。老年患者癌症治疗的决策对医学专业人员来说具有挑战性,因为这个问题伴随着很高的不确定性。由于担心激进的治疗方案会导致发病率随后增加,在许多情况下,只采取了不完整的诊断和治疗措施。回顾文献,几乎有完全的国际共识,即如果对头颈部鳞状细胞癌患者目前的合并症进行全面的术前评估,应以治愈为目的进行治疗。此外,不应排除积极的治疗选择。对相关伴随疾病进行最佳的医学调整显然会改善起点。与年轻对照组相比,治疗相关并发症的发生率并没有显著更高。因此,老年患者应以治愈为目的进行治疗。年龄本身绝不应成为决定应采取何种治愈性治疗的唯一因素。严重全身合并症患者可为例外。