Review on non-surgical treatment for elderly patients with locally advanced head and neck squamous cell carcinoma
10.3760/cma.j.cn113030-20211108-00455
- VernacularTitle:老年局部晚期头颈部鳞癌非手术治疗研究进展
- Author:
Shanshan HE
1
;
Churong LI
;
Sihao CHEN
;
Shilong SHAO
;
Zuxian ZHONG
;
Dan WANG
;
Yi LIU
;
Shichuan ZHANG
Author Information
1. 西南医科大学临床医学院，泸州 646000
- Keywords:
Head and neck squamous cell carcinoma;
Elderly patients;
Chemoradiotherapy;
Targeted therapy;
Immunotherapy
- From:
Chinese Journal of Radiation Oncology
2023;32(2):169-173
- CountryChina
- Language:Chinese
-
Abstract:
With the aging of population, the elderly (≥65 years old) cancer patients have become one of the main populations for cancer care. For inoperable locally advanced head and neck squamous carcinomas, cisplatin-based concurrent chemoradiotherapy is the first-line choice. Several large clinical studies have shown that patients under 70 years of age can still benefit from concurrent chemoradiotherapy, while it should be cautious to apply chemotherapy to patients aged 70-80 years. For elderly patients who are intolerant to cisplatin, carboplatin or other regimens with less gastrointestinal and renal toxicity should be considered. Although anti-epidermal growth factor receptor (EGFR) monoclonal antibodies combined with radiotherapy has been proved to be more effective than radiotherapy alone in total patient population, age-subgroup analysis showed limited benefit in elderly patients. The safety of immune checkpoint inhibitors in elderly patients has been validated and those with high programmed death ligand-1 (PD-L1) expression may benefit from concurrent or neoadjuvant immunotherapy, however, high-level evidence is still lacking. For patients older than 80 years, radiotherapy alone may be superior to concurrent chemoradiotherapy, and hypofractionated radiotherapy for palliative purposes can be safely used in this population.
