Health Science Department (DISSAL), University of Genoa, Italy.
Radiation Oncology Department, Policlinico San Martino Hospital, Genoa, Italy.
Acta Otorhinolaryngol Ital. 2020 Dec;40(6):405-409. doi: 10.14639/0392-100X-N0618.
Over the years, evidence-based data and technical improvements have consolidated the central role of radiation therapy (RT) in head and neck cancer (HNC) treatment, even in the elderly. This survey aimed to describe the management of the elderly HNC patients among Italian Radiation Oncology Departments (RODs) and provide possible suggestions for improvement.
An online survey based on 43 questions was sent to RODs via email. For each RODs, a radiation oncologist with expertise in HNC was invited to answer questions addressing his/her demographic data, ROD multidisciplinary unit (MU) organisation and ROD management policy in elderly HNC patients.
In total, 68 RODs answered, representing centres located in 16 Italian regions. MU was considered the core of HNC patient management in almost all the entire country. However, in many RODs, there was minimal access to a routinely comprehensive geriatric assessment at diagnosis. Most treatments were reported by respondents as curative (89% on average) and the preferred treatment technique was intensity modulated radiation therapy (IMRT). A considerable variation between RODs was found for RT target volumes. There was a relation between the specialist's years of experience and type of concomitant systemic therapy prescribed.
Substantial differences in elderly HNC management have been found, especially concerning patient clinical evaluation and target volume delineation. This survey shows the necessity to design a prospective national trial to provide a uniform treatment strategy and define an effective patient-centred approach.
多年来，循证数据和技术进步巩固了放射治疗（RT）在头颈部癌症（HNC）治疗中的核心作用，即使是在老年人中也是如此。本研究旨在描述意大利放射肿瘤学部门（ROD）对老年 HNC 患者的管理，并为改进提供可能的建议。
通过电子邮件向 ROD 发送了一项基于 43 个问题的在线调查。为每个 ROD，邀请一位在 HNC 方面具有专业知识的放射肿瘤学家回答关于其人口统计学数据、ROD 多学科单位（MU）组织以及 ROD 对老年 HNC 患者管理政策的问题。
共有 68 个 ROD 做出了回应，代表了分布在意大利 16 个地区的中心。MU 被认为是 HNC 患者管理的核心，几乎遍及全国。然而，在许多 ROD 中，在诊断时很少有机会进行常规的全面老年评估。大多数治疗方法被受访者认为是治愈性的（平均 89%），首选的治疗技术是调强放射治疗（IMRT）。ROD 之间在 RT 靶区方面存在相当大的差异。专家的经验年限与规定的同时系统治疗类型之间存在关联。
在老年 HNC 管理方面存在很大差异，尤其是在患者的临床评估和靶区勾画方面。本研究表明有必要设计一项前瞻性的全国性试验，以提供统一的治疗策略并定义有效的以患者为中心的方法。
