Thiagarajan S, Babu T P S, Chakraborthy S, Patil V M, Bhattacharjee A, Balasubramanian S
Department of Surgical Oncology, Malabar Cancer Centre, Thalassery, Kannur, Kerala, India.
Indian J Cancer. 2015 Jul-Sep;52(3):387-90. doi: 10.4103/0019-509X.176734.
The percentage of elderly people with head and neck cancers (HNC) is on the rise. This makes HNC in this group of patients an important issue for healthcare providers. The present study was planned to analyze the patterns of care given to the geriatric patients and to identify the factors influencing the decision making process.
Data of all the elderly patients (≥65 years) registered in the year 2012, with histologically proven HNC (all sites, stages, histopathological types, except lymphoma, sarcoma and cervical metastasis of unknown origin) receiving treatment (definitive/palliative) were collected.
A total of 270 patients were included in this study. The median age was 72 years (range: 65-101), with predominant male population (70%, n = 190). Oral cavity squamous cell carcinoma (SCC) was the most common cancer (57%, n = 154). Eastern Co-Operative Oncology Group performance status (PS) of 0-2 was seen in 91% of the patients. Co-morbidities were present in 139 (51.5%) patients. 50% (n = 134) of the patients received palliative intent treatment, 45% (n = 123) definitive treatment, whereas in 5% (n = 13) the intent was not mentioned. Age, a clinical stage and PS significantly influenced the decision making on the intent of treatment. 208 (77%) patients completed their treatment irrespective of the intent. Age was the only factor influencing treatment completion irrespective of the intent.
Geriatric HNC patients frequently present with advanced disease, having multiple co-morbidities. Hence, a multidisciplinary team management of these patients is essential, also taking into account of the social and financial support available to these patients.
老年头颈癌（HNC）患者的比例正在上升。这使得该组患者的头颈癌成为医疗服务提供者面临的一个重要问题。本研究旨在分析给予老年患者的护理模式，并确定影响决策过程的因素。
收集了2012年登记的所有老年患者（≥65岁）的数据，这些患者经组织学证实患有头颈癌（所有部位、分期、组织病理学类型，但不包括淋巴瘤、肉瘤和不明来源的宫颈转移瘤）并接受了治疗（根治性/姑息性）。
本研究共纳入270例患者。中位年龄为72岁（范围：65 - 101岁），男性占主导（70%，n = 190）。口腔鳞状细胞癌（SCC）是最常见的癌症（57%，n = 154）。91%的患者东部肿瘤协作组体能状态（PS）为0 - 2。139例（51.5%）患者存在合并症。50%（n = 134）的患者接受姑息性治疗，45%（n = 123）接受根治性治疗，而5%（n = 13）未提及治疗意向。年龄、临床分期和PS对治疗意向的决策有显著影响。208例（77%）患者无论治疗意向如何均完成了治疗。年龄是影响治疗完成的唯一因素，与治疗意向无关。
老年头颈癌患者常表现为晚期疾病，合并多种疾病。因此，对这些患者进行多学科团队管理至关重要，同时也要考虑到这些患者可获得的社会和经济支持。
