Nonsurgical Treatment Strategies for Elderly Head and Neck Cancer Patients: An Emerging Subject Worldwide

SIMPLE SUMMARY: Among elderly adults, there is an increasing rate of those receiving chemoradiotherapy to preserve function and maintain quality of life. Many currently used guidelines on therapies for head and neck squamous cell carcinoma (HNSCC) exclude elderly adults, although the number of elderly patients with HNSCC is drastically increasing worldwide. In this review, we present the current status and potential new treatment strategies for elderly patients with HNSCC. Poor tolerance to chemoradiotherapy-related toxicity is a bigger concern in older patients than in younger individuals. Then, we describe toxicities particularly severe in elderly patients and provide an overview of countermeasures in chemotherapy and radiotherapy, particularly with a focus on cisplatin-based chemotherapy (the main treatment for HNSCC). In addition, we describe the molecular target drug therapy and immunotherapy for older patients with HNSCC. ABSTRACT: Consistent with the increasing rate of head and neck cancers among elderly adults, there has been an increase in the rate of those receiving nonsurgical treatments to maintain their function and quality of life. However, various problems, such as poor tolerance to chemoradiotherapy-related toxicity, are of greater concern in elderly adults than in younger individuals. In this review, we describe adverse events that should be particularly noted in elderly patients and provide an overview of countermeasures in nonsurgical treatments. We mainly focus on cisplatin-based chemoradiotherapy—the primary treatment for head and neck squamous cell carcinoma (HNSCC). Furthermore, we review the molecular targeted drugs and immune checkpoint inhibitors for elderly patients with HNSCC. Although the number of older patients is increasing worldwide, clinical trials aimed at determining the standard of care typically enroll younger or well-conditioned elderly patients. There is still very little evidence for treating elderly HNSCC older patients, and the question of optimal treatment needs to be explored.