| 論文種別 | 原著(症例報告除く) |
| 言語種別 | 英語 |
| 査読の有無 | その他(不明) |
| 表題 | Non-surgical definitive treatment and geriatric assessment in older patients with locally advanced head and neck cancer. |
| 掲載誌名 | 正式名：Japanese journal of clinical oncology 略 称：Jpn J Clin Oncol ISSNコード：14653621/03682811 |
| 掲載区分 | 国外 |
| 巻・号・頁 | pp.Online ahead of print |
| 著者・共著者 | Koichi Yasuda, Yoshitaka Honma, Yuri Ueda, Satoshi Saito, Kazuto Matsuura, Tomohiko Miyazaki, Shuhei Takahashi, Fuki Koizumi, Manami Otsuka, Tomohiro Enokida, Yuki Saito, Kaoru Tanaka, Shinya Hiraoka, Takashi Mukaigawa, Yoshinori Imamura, Taiji Koyama, Susumu Okano, Tomoya Yokota, Takeshi Kodaira, Nobuhiro Hanai, Satoaki Nakamura, Naomi Kiyota |
| 発行年月 | 2026/04 |
| 概要 | Population aging is rapidly progressing worldwide, and Japan has the most advanced aging population. Consistent with this trend, the proportion of older patients with head and neck cancer has markedly increased. Non-surgical definitive treatment for locally advanced head and neck cancer consists of radiotherapy (RT) alone or RT combined with systemic therapy; however, optimal treatment selection in older patients remains challenging due to their increased vulnerability to treatment-related toxicities and the limited availability of age-specific evidence. This review summarizes current evidence on non-surgical treatment strategies and the role of geriatric assessment (GA) in older patients with locally advanced oropharyngeal, hypopharyngeal, and laryngeal cancers. Although concurrent chemoradiotherapy (CRT) with high-dose cisplatin remains the standard of care for fit patients, its survival benefit appears attenuated in patients aged 70 years or older. Alternative approaches, including weekly cisplatin-based CRT, RT with other systemic agents, or RT alone, are frequently considered; however, the strength of supporting evidence varies. International guidelines recommend that treatment decisions for older adults be based on overall health status rather than chronological age alone. GA provides a structured framework to evaluate vulnerability across multiple domains, but remains underutilized in routine practice. Individualized, GA-guided treatment strategies with multidisciplinary discussion are essential for optimizing outcomes in this growing patient population. |
| DOI | 10.1093/jjco/hyag057 |
| PMID | 41968981 |