Systemic treatment in elderly head and neck cancer patients: recommendations for clinical practice.

Détails

ID Serval
serval:BIB_E76BF67C06EC
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Systemic treatment in elderly head and neck cancer patients: recommendations for clinical practice.
Périodique
Current opinion in otolaryngology & head and neck surgery
Auteur⸱e⸱s
Szturz P., Bossi P., Vermorken J.B.
ISSN
1531-6998 (Electronic)
ISSN-L
1068-9508
Statut éditorial
Publié
Date de publication
04/2019
Peer-reviewed
Oui
Volume
27
Numéro
2
Pages
142-150
Langue
anglais
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Résumé
Despite the constantly growing number of elderly patients with squamous cell carcinoma of the head and neck (SCCHN), the majority of clinical trials have been focusing on their younger counterparts. However, because of age-related changes and the resulting higher prevalence of frailty, senior people need an adapted evidence-based approach.
Recommendations presented in this article proceed from those relevant for the general patient population taking into consideration the individual process of aging. In this respect, categorization into fit, vulnerable and frail elderly patients was used to guide systemic treatment.
The fit and vulnerable subgroups with locoregionally advanced SCCHN may still benefit from curative treatment, whereas for the remaining cases only palliative measures are usually appropriate. Advanced calendar age is not a contraindication for cisplatin making part of the standard regimens in locally advanced (high-dose 3-weekly schedule concurrent with radiotherapy) and recurrent/metastatic disease (in combination with 5-fluorouracil and cetuximab). In the latter setting, modern immunotherapy with immune checkpoint inhibitors, particularly the antiprogrammed cell death protein-1 (anti-PD-1) agents nivolumab and pembrolizumab, changed clinical practice. These drugs have a favourable toxicity profile making them good candidates even for management of vulnerable patients. Regardless of the chosen strategy, attentive supportive care is of paramount importance.
Mots-clé
Age Factors, Aged, Antineoplastic Agents/administration & dosage, Forecasting, Frail Elderly, Geriatric Assessment, Head and Neck Neoplasms/drug therapy, Head and Neck Neoplasms/pathology, Head and Neck Neoplasms/therapy, Humans, Immunotherapy, Squamous Cell Carcinoma of Head and Neck/drug therapy, Squamous Cell Carcinoma of Head and Neck/pathology, Squamous Cell Carcinoma of Head and Neck/therapy
Pubmed
Web of science
Création de la notice
27/02/2019 12:23
Dernière modification de la notice
06/12/2020 7:26
Données d'usage