Head and neck cancer in the elderly: An overview on the treatment modalities

The percentage of elderly people with head and neck cancers (HNC) is rising due to increasing average lifespan. As with younger patients, elderly patients require a multidisciplinary approach in order to optimise treatment results. The biological, not the chronological, age should be defined individually based on co-morbidities and performance status. A comprehensive geriatric assessment represents the first and essential step for selecting further treatment options. Major improvements have been accomplished in surgical techniques and radiotherapy delivery. Several chemotherapeutic agents and targeted therapies with different toxicity profile are also available. However, the randomised studies that defined the nature of these improvements included only a small proportion of patients older than 65 years. In deciding which treatment strategy would be suitable for an individual elderly patient, we review the literature regarding surgery, radiotherapy, and chemotherapy or their various combinations. (C) 2008 Elsevier Ltd. All rights reserved.