BACKGROUND There are no universally accepted treatment recommendations for elderly patients with head and neck carcinomas. This study investigated whether radical treatment in elderly patients resulted in better survival compared with palliative treatment. METHODS We retrospectively reviewed the medical records of 724 patients aged > 60 years who underwent treatment for primary head and neck carcinomas at Hamamatsu University Hospital. We evaluated the impact of the following: age, sex, the clinical stage, smoking history, alcohol use history, primary tumor site, performance status, and Osaka Head and Neck Comorbidity Index score on overall survival using a Cox proportional hazards model. RESULTS The 5-year overall survival rate was significantly greater for the 646 patients initially treated with radical (curative) therapy than for the 78 patients treated with palliative therapy (p < 0.01). Patients who received palliative treatment in all age groups were more likely to die than were those in the radical treatment group, after controlling for age, sex, and clinical stage of the cancer. Information on the survival status of patients was obtained after a mean follow-up period of 46 months (range 6-205 months). CONCLUSIONS In the absence of contraindications associated with comorbidities, radical treatment protocols should be recommended for elderly patients with head and neck carcinomas because they confer better survival.

中文翻译：

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老年头颈癌患者的治疗：根治性与姑息性治疗的结局分析。

背景技术对于患有头颈癌的老年患者，没有普遍接受的治疗建议。这项研究调查了老年患者中的根治性治疗是否比姑息治疗具有更好的生存率。方法我们回顾性分析了滨松大学医院724例60岁以上的原发性头颈癌患者的病历。我们使用Cox比例风险模型评估了以下因素的影响：年龄，性别，临床阶段，吸烟史，饮酒史，原发肿瘤部位，表现状态以及大阪市头颈合并症指数评分对总体生存的影响。结果最初接受根治性（根治性）治疗的646例患者的5年总生存率明显高于接受姑息治疗的78例患者（p <0.01）。在控制了癌症的年龄，性别和临床阶段之后，所有年龄组接受姑息治疗的患者比根治性治疗组的患者更有可能死亡。平均随访期为46个月（6-205个月），获得了患者的生存状况信息。结论在没有合并症的禁忌症的情况下，应建议老年头颈部癌患者进行彻底的治疗方案，因为它们可带来更好的生存期。在控制了癌症的年龄，性别和临床阶段之后，所有年龄组接受姑息治疗的患者比根治性治疗组的患者更有可能死亡。平均随访期为46个月（6-205个月），获得了患者的生存状况信息。结论在没有合并症的禁忌症的情况下，应建议老年头颈部癌患者进行彻底的治疗方案，因为它们可带来更好的生存期。在控制了癌症的年龄，性别和临床阶段之后，所有年龄组接受姑息治疗的患者比根治性治疗组的患者更有可能死亡。平均随访期为46个月（6-205个月），获得了患者的生存状况信息。结论在没有合并症的禁忌症的情况下，应建议老年头颈部癌患者进行彻底的治疗方案，因为它们可带来更好的生存期。