The findings have recently been published in the journal JAMA Network Open.
As a result of demographic change, the proportion of older oncology patients is rising sharply. Compared to younger patients, cancer treatment is highly individualised due to more frequent and sometimes severe comorbidities, increasing age-related infirmities and reduced physical fitness. It is also important to consider the side effects of treatment, which can affect quality of life. The standard treatment for head and neck cancer is either surgical removal of the tumour followed by radiotherapy, or organ-preserving radiotherapy in combination with chemotherapy. The use of concomitant chemotherapy is particularly controversial because of the physical strain and side effects in older patients. So far, there is only a limited amount of trial data on the best treatment.
An international study involving twelve university hospitals in Europe and the US has investigated the extent to which older head and neck cancer patients benefit from a combination of radiotherapy and chemotherapy on the one hand, or an alternative drug therapy with an antibody against a growth factor receptor (EGFR) on the other. This clinical study shows that adding chemotherapy to radiotherapy is associated with a better chance of survival compared to radiotherapy alone. This benefit was particularly pronounced in patients between 65 and 79 years of age and in those with good general health and few comorbidities. “In particular, fit older patients with minor comorbidities should not be denied this effective therapy simply because of their advanced age,” explains study leader Professor Nils Nicolay: “In contrast, radiotherapy combined with taking the growth factor antibody showed no survival benefit compared to radiotherapy alone.”
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