As a result of demographic change, more older people need cancer treatment, doctors must treat them differently than younger people due to their other health problems, frailty, and decreased physical ability. Doctors need to think about how the treatment could affect their quality of life. To treat head and neck cancer, doctors usually remove the tumor with surgery and then use radiation therapy, or they use radiation therapy and chemotherapy together to preserve the affected organ. Using chemotherapy at the same time can be risky for older patients because of its side effects. However, there isn't much information about the best treatment for older people yet.

A research project was carried out by twelve university hospitals in Europe and the US to study the effectiveness of different treatments for older people with head and neck cancer. They looked at combining radiotherapy and chemotherapy or using a drug that targets a growth factor receptor called EGFR. The study found that adding chemotherapy to radiotherapy improved survival rates compared to radiotherapy alone. This was especially true for patients aged between 65 and 79 who were in good general health and had fewer other health problems. Professor Nils Nicolay, who led the study, explained that fit older patients with minor health problems should not be denied this effective treatment simply because of their age. However, using the growth factor antibody drug alongside radiotherapy did not improve survival rates compared to radiotherapy alone.

The researchers examined the medical records of 1,044 older patients with head and neck squamous cell carcinoma, a type of cancer that affects the mouth, throat, or voice box. These patients were treated with radiotherapy, sometimes with the addition of a drug, between 2005 and 2019. The study was led by Leipzig University Hospital, and they are now creating an international registry for older patients diagnosed with head and neck cancer. More than 20 centres from Europe, the US and Australia have shown an interest in taking part. This registry will not only record oncological data but also include other information, such as a comprehensive geriatric assessment, health-related quality of life data, and the frequency of patients regretting their treatment decisions. Dr Alexander Rühle, the lead author and co-leader of the study, said that they will work with other international research groups to further understand which older patients will benefit from combined radiotherapy and chemotherapy. They will also create tools to help doctors make joint therapy decisions based on individual patient data.

Professor Nils Nicolay and Dr Alexander Rühle began the study while they were working at the University of Freiburg Medical Center and finished it after they moved to Leipzig. Nicolay is currently a Professor of Radiotherapy and Radiooncology at Leipzig University's Faculty of Medicine, starting from September 1, 2022. This appointment also involves leading the Department of Radiooncology at Leipzig University Hospital. (PB/Newswise)