Evidence-based organ-sparing radiotherapy in head and neck cancer

Objective Due to the current coronavirus disease 2019 (COVID-19) pandemic, otolaryngologists face novel challenges when treating patients with head and neck cancer. The purpose of this review is to evaluate the current evidence surrounding the treatment of these patients during this pandemic and to provide evidence-based recommendations with attention to increased risk in this setting. Data Sources A review of the literature was performed with PubMed. Because recently published articles on this topic may not yet be indexed into PubMed, otolaryngology journals were hand searched for relevant articles. Guidelines from national organizations were reviewed to identify additional relevant sources of information. Review Methods Two groups of search terms were created: one with terms related to COVID-19 and another with terms related to head and neck cancer and its management. Searches were performed of all terms in each group as well as combinations of terms between groups. Searches and subsequent exclusion of articles were performed in accordance with the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses). Additional articles were identified after relevant journals and guidelines from national organizations were reviewed. Conclusions Patients with head and neck mucosal malignancy require continued treatment despite the current pandemic state. Care must be taken at all stages of treatment to minimize the risk to patients and health care workers while maintaining focus on minimizing use of limited resources. Implications for Practice Patient care plans should be guided by best available evidence to optimize outcomes while maintaining a safe environment in the setting of this pandemic.

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Commentary: Induction Chemotherapy for Head and Neck Cancer: Hypothesis‐Based Rather Than Evidence‐Based Medicine

The Oncologist ◽

10.1634/theoncologist.12-8-975 ◽

2007 ◽

Vol 12 (8) ◽

pp. 975-977 ◽

Cited By ~ 17

Author(s):

Avraham Eisbruch

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Induction Chemotherapy ◽

Neck Cancer ◽

Evidence Based Medicine ◽

Evidence Based ◽

Based Medicine

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A phase II trial of neoadjuvant chemotherapy (NCT), organ-sparing surgery, and radiation in squamous cell head and neck cancer (SCHNC): Results of neoadjuvant chemotherapy

Journal of Clinical Oncology ◽

10.1200/jco.2004.22.90140.5617 ◽

2004 ◽

Vol 22 (14_suppl) ◽

pp. 5617-5617

Author(s):

S. Shibata ◽

B. Paz ◽

J. Ellenhorn ◽

N. Vora ◽

G. Somlo ◽

...

Keyword(s):

Head And Neck Cancer ◽

Neoadjuvant Chemotherapy ◽

Head And Neck ◽

Phase Ii ◽

Neck Cancer ◽

Squamous Cell ◽

Phase Ii Trial ◽

Organ Sparing

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Current concepts of surveillance and its significance in head and neck cancer

Annals of The Royal College of Surgeons of England ◽

10.1308/003588411x604794 ◽

2011 ◽

Vol 93 (8) ◽

pp. 576-582 ◽

Cited By ~ 12

Author(s):

Kapila Manikantan ◽

Raghav C Dwivedi ◽

Suhail I Sayed ◽

KA Pathak ◽

Rehan Kazi

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Cost Effective ◽

Second Primary ◽

Evidence Based ◽

Significant Cost ◽

Second Primary Tumours ◽

Cost Implications

Follow-up in head and neck cancer (HNC) is essential to detect and manage locoregional recurrence or metastases, or second primary tumours at the earliest opportunity. A variety of guidelines and investigations have been published in the literature. This has led to oncologists using different guidelines across the globe. The follow-up protocols may have unnecessary investigations that may cause morbidity or discomfort to the patient and may have significant cost implications. In this evidence-based review we have tried to evaluate and address important issues like the frequency of follow-up visits, clinical and imaging strategies adopted, and biochemical methods used for the purpose. This review summarises strategies for follow-up, imaging modalities and key investigations in the literature published between 1980 and 2009. A set of recommendations is also presented for cost-effective, simple yet efficient surveillance in patients with head and neck cancer.

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