The low evidence to treat elderly patients with head and neck cancer

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology Pub Date : 2025-12-01 Epub Date: 2025-10-29 DOI:10.1016/j.oraloncology.2025.107764

Beatriz Bertin , Luiz Paulo Kowalski , Leandro Luongo Matos

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引用次数: 0

Abstract

Treatment of head and neck cancer in older patients is particularly complex, as they are more prone to side effects and treatment-related toxicity due to age-related physiological changes. Nevertheless, they should still receive care based on the best available standards and protocols, since alternative approaches may increase the risk of treatment failure and mortality. The core issue lies in the lack of evidence-based protocols tailored to the specific needs of older patients, as most clinical trials seam to focus on younger populations. The objective of this study was to determine the rate of patients over 65 years of age included in clinical trials of treatments for head and neck cancer. In this context, the study aims to shed light on the proportion of clinical evidence that can be safely extrapolated to the treatment of older patients with head and neck cancer. To achieve this, we analyzed the age distribution of patients enrolled in clinical trials cited by the National Comprehensive Cancer Network (NCCN) in the NCCN Guidelines Version 2.2025: Head and Neck Cancers. Less than one-fourth of patients enrolled in the NCCN-referenced clinical trials were over 65 years of age, reinforcing concerns about the applicability of current protocols to this population. To address this gap, the most effective strategy is to promote the generation and dissemination of evidence-based data that actively includes older adults worldwide.

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治疗老年头颈癌的证据不足

老年头颈癌患者的治疗尤其复杂，因为他们更容易由于与年龄相关的生理变化而产生副作用和治疗相关的毒性。尽管如此，他们仍应根据现有的最佳标准和方案接受治疗，因为其他方法可能增加治疗失败和死亡的风险。核心问题在于缺乏针对老年患者特殊需求的循证方案，因为大多数临床试验都将重点放在年轻人群上。这项研究的目的是确定65岁以上的患者在头颈癌治疗的临床试验中的比例。在此背景下，该研究旨在阐明临床证据的比例，这些证据可以安全地推断出老年头颈癌患者的治疗方法。为了实现这一目标，我们分析了国家综合癌症网络（NCCN）在NCCN指南2.2025版：头颈部癌症中引用的临床试验中入组患者的年龄分布。在nccn引用的临床试验中，不到四分之一的患者年龄超过65岁，这加强了人们对当前方案在这一人群中的适用性的担忧。要弥补这一差距，最有效的战略是促进生成和传播包括全世界老年人在内的循证数据。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oral oncology 医学-牙科与口腔外科

CiteScore

8.70

自引率

10.40%

发文量

505

审稿时长

20 days

期刊介绍： Oral Oncology is an international interdisciplinary journal which publishes high quality original research, clinical trials and review articles, editorials, and commentaries relating to the etiopathogenesis, epidemiology, prevention, clinical features, diagnosis, treatment and management of patients with neoplasms in the head and neck. Oral Oncology is of interest to head and neck surgeons, radiation and medical oncologists, maxillo-facial surgeons, oto-rhino-laryngologists, plastic surgeons, pathologists, scientists, oral medical specialists, special care dentists, dental care professionals, general dental practitioners, public health physicians, palliative care physicians, nurses, radiologists, radiographers, dieticians, occupational therapists, speech and language therapists, nutritionists, clinical and health psychologists and counselors, professionals in end of life care, as well as others interested in these fields.