Head and Neck Cancers, Version 1.2015

Abstract

These NCCN Guidelines Insights focus on recent updates to the 2015 NCCN Guidelines for Head and Neck (H&N) Cancers. These Insights describe the different types of particle therapy that may be used to treat H&N cancers, in contrast to traditional radiation therapy (RT) with photons (x-ray). Research is ongoing regarding the different types of particle therapy, including protons and carbon ions, with the goals of reducing the long-term side effects from RT and improving the therapeutic index. For the 2015 update, the NCCN H&N Cancers Panel agreed to delete recommendations for neutron therapy for salivary gland cancers, because of its limited availability, which has decreased over the past 2 decades; the small number of patients in the United States who currently receive this treatment; and concerns that the toxicity of neutron therapy may offset potential disease control advantages.

Patterns of Care for Patients With Early-Stage Glottic Cancer Undergoing Definitive Radiation Therapy: A National Cancer Database Analysis

“…An additional factor outside the scope of this analysis that may nevertheless underlie the persistent prevalence of CFxn is the ambiguity in clinical guidelines available to oncologists treating head and neck cancer. While radiotherapy-focused guidelines describe the Yamazaki trial in detail and explicitly rate HFxn as “usually appropriate” and CFxn as “usually not appropriate” [8], more general multidisciplinary cancer guidelines do not mention the local control advantage conferred by HFxn and permit either CFxn or HFxn for Tis-T2N0 glottic cancer [9]. Broadening utilization of HFxn will ultimately require heightened efforts to educate radiation oncologists and consistency among clinical guidelines in uniformly advocating HFxn for the radiotherapeutic management of early-stage glottic cancer.…”

“…Perhaps as a result of these comparable survival outcomes between conventional fractionation and hypofractionation, national guidelines for the radiotherapeutic management of early-stage glottic SCC are inconsistent, with the American College of Radiology’s Appropriateness Criteria favoring hypofractionation [8] and the National Comprehensive Cancer Network guidelines deeming either schedule suitable [9]. …”

Invasive myoepithelial carcinoma ex pleomorphic adenoma of the major salivary gland: two case reports

“…Although the efficacy of radiation therapy for MEC ex PA remains unknown, adjuvant radiotherapy with or without chemotherapy is suggested for high-grade malignancies with residual tumor/close margin, neural/perineural invasion, soft-tissue extension, lymph node involvement, or lymphatic/vascular invasion, as well as after salvage surgery for recurrent tumors [12, 19]. Moreover, the efficacy and the optimal timing of chemotherapy for MEC ex PA too remain unclear.…”

Nomograms predicting long-term overall survival and cancer-specific survival in head and neck squamous cell carcinoma patients

“…The National Comprehensive Cancer Network (NCCN) guidelines [8] currently recommend the use of the American Joint Committee on Cancer (AJCC) Staging Manual (7 th edition) to predict HNSCC patient prognosis [9]. However, HNSCC patient stage, from I to IV, is only based on TNM stage.…”