The low evidence to treat elderly patients with head and neck cancer

Treatment of head and neck cancer in older patients is particularly complex, as they are more prone to side effects and treatment-related toxicity due to age-related physiological changes. Nevertheless, they should still receive care based on the best available standards and protocols, since alternative approaches may increase the risk of treatment failure and mortality. The core issue lies in the lack of evidence-based protocols tailored to the specific needs of older patients, as most clinical trials seam to focus on younger populations. The objective of this study was to determine the rate of patients over 65 years of age included in clinical trials of treatments for head and neck cancer. In this context, the study aims to shed light on the proportion of clinical evidence that can be safely extrapolated to the treatment of older patients with head and neck cancer. To achieve this, we analyzed the age distribution of patients enrolled in clinical trials cited by the National Comprehensive Cancer Network (NCCN) in the NCCN Guidelines Version 2.2025: Head and Neck Cancers. Less than one-fourth of patients enrolled in the NCCN-referenced clinical trials were over 65 years of age, reinforcing concerns about the applicability of current protocols to this population. To address this gap, the most effective strategy is to promote the generation and dissemination of evidence-based data that actively includes older adults worldwide.