Syrigos Kostas N, Karachalios Dimitris, Karapanagiotou Eleni M, Nutting Christopher M, Manolopoulos Leonidas, Harrington Kevin J
Head, Oncology Unit Third Department of Medicine, Sotiria General Hospital, Athens Medical School, Building Z, 152 Mesogion Avenue, 115 27, Athens, Greece.
Cancer Treat Rev. 2009 May;35(3):237-45. doi: 10.1016/j.ctrv.2008.11.002. Epub 2008 Dec 18.
The percentage of elderly people with head and neck cancers (HNC) is rising due to increasing average lifespan. As with younger patients, elderly patients require a multidisciplinary approach in order to optimise treatment results. The biological, not the chronological, age should be defined individually based on co-morbidities and performance status. A comprehensive geriatric assessment represents the first and essential step for selecting further treatment options. Major improvements have been accomplished in surgical techniques and radiotherapy delivery. Several chemotherapeutic agents and targeted therapies with different toxicity profile are also available. However, the randomised studies that defined the nature of these improvements included only a small proportion of patients older than 65 years. In deciding which treatment strategy would be suitable for an individual elderly patient, we review the literature regarding surgery, radiotherapy, and chemotherapy or their various combinations.
由于平均寿命延长,老年头颈癌(HNC)患者的比例正在上升。与年轻患者一样,老年患者需要多学科方法来优化治疗效果。应根据合并症和体能状态单独确定生物学年龄而非实际年龄。全面的老年医学评估是选择进一步治疗方案的首要且关键步骤。手术技术和放疗实施已取得重大进展。也有几种具有不同毒性特征的化疗药物和靶向疗法。然而,确定这些改善性质的随机研究仅纳入了一小部分65岁以上的患者。在决定哪种治疗策略适合个体老年患者时,我们回顾了有关手术、放疗、化疗或其各种组合的文献。