Abstract
Japan’s population is aging at an unprecedented rate. In 2012 the average life span of Japanese women was 86.21 years and that of men was 79.94. Accordingly, we must manage elderly patients with head and neck cancer to estimate the situation of past treatments of such patients. In this study we reviewed the treatments of elderly patients over 74 years old with advanced head and neck cancer at the Jichi Medical University Hospital. From January 1970 to September 2014, 125 elderly patients (aged ≥75 years) diagnosed with stage III / IV head and neck cancer (excluding thyroid cancer) at the Hospital were identified retrospectively. Radiation was performed in 46 patients, of which three patients discontinued radiation due to aspiration pneumonia and deliria. Within one month after radiation treatment, complications caused by radiation were found in six patients; the complications were aspiration pneumonia, deliria, cerebral infarction, and acute renal failure. Surgery was performed in 34 patients: total laryngectomy in 11 patients, pharyngo-laryngo-esophagectomy with reconstruction in 10 patients, and tongue resection with reconstruction in three patients. Among those patients who underwent tongue resection with reconstruction, aspiration pneumonia was observed in two patients; total laryngectomy was performed in one of these patients because of repeated aspiration pneumonia. Best supportive care was provided for 28 patients. Radiation for elderly patients with advanced head and neck cancers may cause complications such as aspiration pneumonia and deliria. We consider that radiation is riskier for elderly patients than younger patients. Surgery to separate the airway from the pharynx space, such as total laryngectomy and pharyngo-laryngo-esophagectomy with reconstruction, is tolerable in elderly patients.
