Multidisciplinary approach of head and neck cancer in the elderly: an update.

Squamous-cell carcinoma of the head and neck (SCCHN) represents the sixth most common malignancy and accounts for approximately 6% of new cancer cases annually worldwide. Although the majority of cases occur between the fifth and sixth decades of life, their onset in patients older than 60 years is not rare and up to one fourth of SCCHN cases are diagnosed in patients older that 70 years. As the elderly population with SCCHN is constantly growing and as elderly cancer patients are severely under-represented in clinical trials, there is a clear need to address the particular aspects of this specific patient group, especially in the context of novel multidisciplinary cancer approaches. The frailty of elderly patients with SCCHN is further exacerbated by the high incidence of smoking and alcohol abuse and the presence of substantial cardiovascular, respiratory or metabolic comorbidities that may hamper optimal therapeutic strategies. Herein, we review current and emerging treatment approaches, including improved surgical techniques attempting to improve radicality of excision while preserving functionality, the incorporation of sophisticated techniques in radiotherapy and the implementation of novel chemotherapeutic regimens and molecular targeted agents in an effort to reduce toxicity without compromising efficacy. We also discuss the particular characteristics that render this patient population a unique entity and we emphasize on the need for a multidisciplinary approach in o...
Source: Head and Neck Oncology - Category: Cancer & Oncology Source Type: research