Clinical decision pathway and management of locally advanced head and neck squamous cell carcinoma: A multidisciplinary consensus in Asia-Pacific
- Author(s)
- Guo, Y; Nakashima, T; Cho, BC; Lim, DW; Yang, MH; Lou, PJ; Corry, J; Lin, JC; Zhu, GP; Kim, KH; Zhang, B; Li, Z; Hong, RL; Ng, JYS; Tan, EM; Liu, YP; Stylianou, C; Spiteri, C; Porceddu, S;
- Journal Title
- Oral Oncology
- Publication Type
- Research article
- Abstract
- OBJECTIVES: To develop consensus on patient characteristics and disease-related factors considered in deciding treatment approaches for locally advanced head and neck squamous cell carcinoma (LA-HNSCC) based on real-world treatment patterns in 4 territories in Asia-Pacific. METHODS: A three-round modified Delphi involving a multidisciplinary panel of HN surgeons, medical oncologists, and radiation oncologists was used. Of 41 panelists recruited, responses of 26 from Australia, Japan, Singapore, and Taiwan were analyzed. All panelists had ≥five years' experience managing LA-HNSCC patients and treated ≥15 patients with LA-HNSCC annually. RESULTS: All statements on definitions of LA-HNSCC, treatment intolerance and cisplatin dosing reached consensus. 4 of 7 statements on unresectability, 2 of 4 on adjuvant chemoradiotherapy, 7 of 13 on induction chemotherapy, 1 of 8 on absolute contraindications and 7 of 11 on relative contraindications to high-dose cisplatin did not reach consensus. In all territories except Taiwan, high-dose cisplatin was preferred in definitive and adjuvant settings for patients with no contraindications to cisplatin; weekly cisplatin (40 mg/m(2)) preferred for patients with relative contraindications to high-dose cisplatin. For Taiwan, the main treatment option was weekly cisplatin. For patients with absolute contraindications to cisplatin, carboplatin ± 5-fluorouracil or radiotherapy alone were preferred alternatives in both definitive and adjuvant settings. CONCLUSION: This multidisciplinary consensus provides insights into management of LA-HNSCC in Asia-Pacific based on patient- and disease-related factors that guide selection of treatment modality and systemic treatment. Despite strong consensus on use of cisplatin-based regimens, areas of non-consensus showed that variability in practice exists where there is limited evidence.
- Publisher
- Elsevier
- Keywords
- Humans; Squamous Cell Carcinoma of Head and Neck/drug therapy; Cisplatin/therapeutic use; *Carcinoma, Squamous Cell/pathology; *Head and Neck Neoplasms/drug therapy; Consensus; Chemoradiotherapy/adverse effects; Carboplatin; Asia; Antineoplastic Combined Chemotherapy Protocols/therapeutic use; Asia Pacific; Australia; Chemoradiotherapy; Delphi technique; Head and Neck Neoplasms*/therapy; La hnscc; Squamous Cell Carcinoma of Head and Neck; Treatment algorithms
- Department(s)
- Radiation Oncology
- Publisher's Version
- https://doi.org/10.1016/j.oraloncology.2023.106657
- Open Access at Publisher's Site
10.1016/j.oraloncology.2023.106657- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2024-02-01 06:24:16
Last Modified: 2024-02-22 12:37:10