Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700, RB, Groningen, the Netherlands.
Department of Experimental and Clinical Biomedical Sciences, Radiation Oncology Unit, University of Florence, Azienda Ospedaliero-Universitaria Careggi, Largo G. Alessandro Brambilia, 3, 50134 Florence, Italy.
J Geriatr Oncol. 2021 Nov;12(8):1261-1265. doi: 10.1016/j.jgo.2021.05.007. Epub 2021 May 11.
We aimed to assess patterns of care delivered to older patients with locally advanced head and neck squamous cell carcinoma (LA-HNSCC), and to analyze the use of geriatric assessment (GA) and assessment of quality of life (QoL).
Members of the head and neck cancer group and the older task force of the European Organisation for Research and Treatment of Cancer (EORTC), members the European Head and Neck Society and members of national groups in Europe were asked to complete a questionnaire about treatment delivered, use of GA, and QoL assessment in older patients with LA-HNSCC.
Investigators from 111 centers replied, including 90 (81.1%) academic centers, 16 (14.4%) community hospitals, and 5 (4.5%) private clinics. Large differences in treatment patterns were found. For instance, for oropharyngeal carcinoma, one third of the centers indicated that they treat <5% of older patients with chemoradiation, while 18 centers (16.2%) treat >40% of older patients with chemoradiation. Fourteen centers (12.6%) routinely perform GA, while 43 centers (38.7%) never do, and 39 centers (35.1%) sometimes do. QoL is assessed on a routine basis in one fifth of the centers.
Large differences exist across institutions in the patterns of care delivered to older patients with LA-HNSCC. Prospective studies are required to learn how GA can guide treatment decisions, and how QoL and treatment outcome can be improved. For that, consensus on standard of care is essential.
评估局部晚期头颈部鳞状细胞癌（LA-HNSCC）老年患者的治疗模式，并分析老年综合评估（GA）和生活质量（QoL）评估的应用。
欧洲癌症研究和治疗组织（EORTC）头颈部癌症组和老年工作组的成员、欧洲头颈部协会的成员以及欧洲各国的成员被要求填写一份关于治疗、GA 应用和 LA-HNSCC 老年患者 QoL 评估的问卷。
111 个中心的调查员回复了问卷，包括 90 个（81.1%）学术中心、16 个（14.4%）社区医院和 5 个（4.5%）私人诊所。治疗模式存在很大差异。例如，对于口咽癌，三分之一的中心表示他们仅用放化疗治疗<5%的老年患者，而 18 个中心（16.2%）则用放化疗治疗>40%的老年患者。14 个中心（12.6%）常规进行 GA，而 43 个中心（38.7%）从不进行，39 个中心（35.1%）有时进行。五分之一的中心常规评估 QoL。
LA-HNSCC 老年患者的治疗模式在各机构之间存在很大差异。需要前瞻性研究来了解 GA 如何指导治疗决策，以及如何改善 QoL 和治疗效果。为此，必须达成关于标准治疗的共识。
