Head and neck cancer in geriatric patients: Analysis of the pattern of care given at a tertiary cancer care center.

BACKGROUND AND AIM: The percentage of elderly people with head and neck cancers (HNC) is on the rise. This makes HNC in this group of patients an important issue for healthcare providers. The present study was planned to analyze the patterns of care given to the geriatric patients and to identify the factors influencing the decision making process. MATERIALS AND METHODS: Data of all the elderly patients (≥65 years) registered in the year 2012, with histologically proven HNC (all sites, stages, histopathological types, except lymphoma, sarcoma and cervical metastasis of unknown origin) receiving treatment (definitive/palliative) were collected. RESULTS: A total of 270 patients were included in this study. The median age was 72 years (range: 65–101), with predominant male population (70%, n = 190). Oral cavity squamous cell carcinoma (SCC) was the most common cancer (57%, n = 154). Eastern Co‑Operative Oncology Group performance status (PS) of 0–2 was seen in 91% of the patients. Co‑morbidities were present in 139 (51.5%) patients. 50% (n = 134) of the patients received palliative intent treatment, 45% (n = 123) definitive treatment, whereas in 5% (n = 13) the intent was not mentioned. Age, a clinical stage and PS significantly influenced the decision making on the intent of treatment. 208 (77%) patients completed their treatment irrespective of the intent. Age was the only factor influencing treatment completion irrespective of the intent. CONCLUSION: Geriatric HNC patients frequently present with advanced disease, having multiple co‑morbidities. Hence, a multidisciplinary team management of these patients is essential, also taking into account of the social and financial support available to these patients.

Improvement of xylanase production in solid state fermentation by alkali-tolerant Aspergillus fumigatus MKU1 using a fractional factorial design.

Optimization of media for the maximum production of xylanase by Aspergillus fumigatus MKUI was carried out using De Meo's fractional factorial design with seven components such as NaNO3, K2HPO4, MgSO4, FeSO4. KCl, peptone and yeast extract. A. fumigatus produced a maximum of 700 U/gds of enzyme after 48 hr of incubation (before optimization). After two steps of optimization, the medium designed favoured a 2.8 fold (1950 U/gds) increase in xylanase production by A. fumigatus. Optimized medium for Aspergillus fumigatus contained (g/l) NaNO3, 15; K2HPO4, 15; MgSO4, 5; FeSO4, 0.009; KCI, 0.5; peptone, 20; and yeast extract, 10.