A specific approach for elderly patients with head and neck cancer
| Autor: | Alexandre Bozec, Cécile Ortholan, Yazid Belkacemi, Karen Benezery, Olivier Dassonville, Gilles Poissonnet, Nicole Guiochet |
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| Rok vydání: | 2011 |
| Předmět: |
Cancer Research
medicine.medical_specialty medicine.medical_treatment Population Context (language use) Medicine Humans Pharmacology (medical) Intensive care medicine Adverse effect education Aged Pharmacology Aged 80 and over education.field_of_study Evidence-Based Medicine business.industry Nutritional Support Head and neck cancer Malnutrition medicine.disease Clinical trial Radiation therapy Oncology Head and Neck Neoplasms Relative risk Practice Guidelines as Topic business |
| Zdroj: | Anti-cancer drugs. 22(7) |
| ISSN: | 1473-5741 |
| Popis: | Approximately 10% of head and neck (HN) tumors occur in patients aged more than or equal to 80 years. In this population, the main challenge for physicians is to deal with the benefit/risk ratio of treatments and tumor-related symptoms. As elderly patients are generally excluded from clinical trials, there is a lack of evidence-based data with regard to the most appropriate multidisciplinary management. The prevalence of frailty and the pattern of comorbidities in this specific population are still unknown. The management of these tumors in a geriatric context is complex due to the high risk of toxicity of locoregional treatments. Thus, physicians often have to adapt to the treatment schedule to decrease potential adverse effects even with a risk of undertreatment. A retrospective series reported that the treatment delivered to elderly patients presenting with HN tumor complies with an institution's policy in less than 50% of cases, emphasizing the need to assess the outcome of personalized/adapted treatment in geriatric patients. The major issue is to determine which adaptation could be carried out, and then, what could be the respective individual benefit/risk ratio of each adaptation. In this review, we will focus on the locoregional management of elderly patients, and develop the issue of adapted local treatment. We will discuss the feasibility of adapted surgery and radiotherapy and provide current evidence-based data that may allow physicians involved in locoregional treatment of elderly patients with HN cancers to be acquainted with practical guidelines. Then, we will highlight the importance of nutritional support in this population in which the prevalence of malnutrition is high. |
| Databáze: | OpenAIRE |
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