Breast Cancer

Breast cancer appears frequently in females over 60 years. Older patients with early stage disease must be treated with surgical resection of the tumor [27]. Patients with low expectancy of life and hormone receptor positive tumor can be treated with only endocrine therapy: aromatase inhibitors offer a better control than tamoxifen to control the disease in these patients [28]. Sentinel node biopsy should be considered for patients in whom it might affect treatment decisions. Tumor stage I/II, in older women, are in 70 % HER2 negative and hormone receptor positive, these patients may be treated in advance with hormone therapy. Radiation therapy is not indicated for older patients. Studies show no difference in survival in older patients submitted to radiotherapy after resection.

Head and Neck Cancer

Surgical resection of the tumors can be done in patients over 70 years with the same benefits as younger patients. Toxicity is however higher in patients with comorbidities. Toxicity occurred in 63 % of older patients (>70 years) compared with 54 % of younger patients. Bilateral resection, male sex, being more than 70 years old and at an advanced stage were all associated with higher risk of toxicity [29]. Radiotherapy can also be indicated for older patients. Functional acute toxicity may be more severe in older patients (67 % versus 49 %), with no difference in survival [30]. Data from clinical trials using induced chemotherapy or chemoradiotherapy in patients of more than 70 years are rare.

 
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