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Homma A, Ando M, Hanai N, Harada H, Honma Y, Kanda T, Kano S, Kawakita D, Kiyota N, Kizawa Y, Nakagawa M, Ogawa T, Shinomiya H, Shinozaki T, Suzuki M, Tsuji T, Yasuda K, Zenda S, Kodaira T, Kirita T, Nibu KI. Summary of Japanese clinical practice guidelines for head and neck cancer - 2022 update edited by the Japan society for head and neck cancer. Auris Nasus Larynx 2024; 51:174-188. [PMID: 37482431 DOI: 10.1016/j.anl.2023.07.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 07/25/2023]
Abstract
The aim of the "Japanese Clinical Practice Guidelines for Head and Neck Cancer - 2022 Update" is to review the latest evidence regarding head and neck cancer and to present the current standard approaches for diagnosis and treatment. These evidence-based recommendations were created with the consensus of the Guideline Committee, which is composed of otorhinolaryngologists and head and neck surgeons, together with radiologists, radiation oncologists, medical oncologists, plastic surgeons, dentists, palliative care physicians, and rehabilitation physicians. These guidelines were created by the Clinical Practice Guideline Committee of the Japan Society for Head and Neck Cancer based on the "Head and Neck Cancer Treatment Guidelines 2018 Edition," and the revised draft was compiled after evaluation by the Assessment Committee and public comments. The 'Clinical questions and recommendations' section consists of 13 categories, and 59 clinical questions are described in total. Here we describe 6 clinical questions specific to other sets of guidelines with recommendations and comments.
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Affiliation(s)
- Akihiro Homma
- Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15, W7, Kita-ku, Sapporo 060-8638, Japan.
| | - Mizuo Ando
- Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Nobuhiro Hanai
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Hiroyuki Harada
- Department of Oral and Maxillofacial Surgical Oncology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshitaka Honma
- Department of Head and Neck, Esophageal Medical Oncology. National Cancer Center Hospital, Tokyo, Japan
| | - Tomonori Kanda
- Department of Radiology, Kobe University School of Medicine, Kobe, Japan
| | - Satoshi Kano
- Department of Otolaryngology-Head & Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15, W7, Kita-ku, Sapporo 060-8638, Japan
| | - Daisuke Kawakita
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Naomi Kiyota
- Department of Medical Oncology and Hematology, Kobe University Hospital, Kobe, Japan
| | - Yoshiyuki Kizawa
- Department of Palliative and Supportive Care, Institute of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Masahiro Nakagawa
- Department of Plastic and Reconstructive Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Takenori Ogawa
- Department of Otolaryngology-Head and Neck Surgery, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hirotaka Shinomiya
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
| | - Takeshi Shinozaki
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Motoyuki Suzuki
- Department of Otolaryngology - Head & Neck Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tetsuya Tsuji
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Koichi Yasuda
- Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan
| | - Sadamoto Zenda
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Takeshi Kodaira
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Tadaaki Kirita
- Department of Oral and Maxillofacial Surgery, Nara Medical University, Nara-Kashihara, Japan
| | - Ken-Ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Hospital and Graduate School of Medicine, Kobe, Japan
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Arboleda LPA, Neves AB, Kohler HF, Vartanian JG, Candelária LM, Borges MF, Fernandes GA, de Carvalho GB, Kowalski LP, Brennan P, Santos‐Silva AR, Curado MP. Overview of glottic laryngeal cancer treatment recommendation changes in the NCCN guidelines from 2011 to 2022. Cancer Rep (Hoboken) 2023; 6:e1837. [PMID: 37288471 PMCID: PMC10432469 DOI: 10.1002/cnr2.1837] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 04/27/2023] [Accepted: 05/09/2023] [Indexed: 06/09/2023] Open
Abstract
BACKGROUND The treatment of glottic cancer remains challenging, especially with regard to morbidity reduction and larynx preservation rates. The National Comprehensive Cancer Network (NCCN) has published guidelines to aid decision-making about this treatment according to the tumor site, clinical stage, and patient medical status. AIM The present review was conducted to identify changes in the NCCN guidelines for glottic cancer treatment made between 2011 and 2022 and to describe the published evidence concerning glottic cancer treatment and oncological outcomes in the same time period. METHODS AND RESULTS Clinical practice guidelines for head and neck cancer published from 2011 up to 2022 were obtained from the NCCN website (www.NCCN.org). Data on glottic cancer treatment recommendations were extracted, and descriptive analysis was performed. In addition, a review of literature registered in the PubMed database was performed to obtain data on glottic cancer management protocols and treatment outcomes from randomized controlled trials, systematic reviews, and meta-analyses published from 2011 to 2022. In total, 24 NCCN guidelines and updates and 68 relevant studies included in the PubMed database were identified. The main guideline changes made pertained to surgical and systemic therapies, the consideration of adverse features, and new options for the treatment of metastatic disease at initial presentation. Early-stage glottic cancer received the most research attention, with transoral endoscopic laser surgery and radiotherapy assessed and compared as the main treatment modalities. Reported associations between treatment types and survival rates for this stage of glottic cancer appear to be similar, but functional outcomes can be highly compromised. CONCLUSION NCCN panel members provide updated recommendations based on currently accepted treatment approaches for glottic cancer, constantly reviewing new surgical and non-surgical techniques. The guidelines support decision-making about glottic cancer treatment that should be individualized and prioritize patients' quality of life, functionality, and preferences.
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Affiliation(s)
| | | | - Hugo Fontan Kohler
- Head and Neck Surgery and Otorhinolaryngology DepartmentA.C. Camargo Cancer CenterSão PauloBrazil
| | - José Guilherme Vartanian
- Head and Neck Surgery and Otorhinolaryngology DepartmentA.C. Camargo Cancer CenterSão PauloBrazil
| | | | - Matheus Ferraz Borges
- Group of Epidemiology and Statistics on CancerA.C. Camargo Cancer CenterSão PauloSPBrazil
| | | | | | - Luiz Paulo Kowalski
- Head and Neck Surgery and Otorhinolaryngology DepartmentA.C. Camargo Cancer CenterSão PauloBrazil
- Head and Neck Surgery Department, Faculdade de MedicinaUniversidade de São PauloSão PauloBrazil
| | - Paul Brennan
- International Agency for Research on CancerGenomic Epidemiology BranchLyonFrance
| | | | - Maria Paula Curado
- Group of Epidemiology and Statistics on CancerA.C. Camargo Cancer CenterSão PauloSPBrazil
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Lee TH, Lee JH, Kwon SK, Chung EJ, Wu HG. Hypofractionated radiotherapy for early stage glottic cancer: efficacy of 3.5 Gy per fraction. Radiat Oncol J 2022; 40:120-126. [PMID: 35796115 PMCID: PMC9262701 DOI: 10.3857/roj.2021.01025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 03/11/2022] [Indexed: 11/26/2022] Open
Abstract
Purpose The purpose of this study was to evaluate the treatment outcomes and toxicity profile of patients with early glottic cancer who underwent hypofractionated radiation therapy (RT) with 3.5 Gy per fraction. Materials and Methods A retrospective review was performed of the medical records of 35 patients with early stage (T1-2N0M0) glottic cancer who underwent definitive RT. The dose fractionation scheme was 59.5 Gy in 17 fractions. Posterior commissure was excluded from the clinical target volume (CTV) for 26 patients (74.3%) without glottic lesions close to this region. Results With a median follow-up of 16.23 months (range, 6.82 to 67.15 months), no local, regional, or distant recurrence was reported. Acute hoarseness (65.7%), mucositis (68.6%), radiation dermatitis (60.0%) was frequent. One patient (2.9%) reported grade 3 acute toxicity (mucositis) and there was no grade 4–5 acute toxicity. There was no grade ≥3 late toxicities; however, grade 1 late intermittent hoarseness was frequent (45.7%). The receiver operative characteristic analysis revealed that mean hypopharyngeal dose was predictive for acute grade ≥2 mucositis (area under the curve=0.9314; 95% confidence interval, 0.8524–1). The optimal threshold of mean hypopharyngeal dose for occurrence of acute grade ≥2 mucositis was 26.31 Gy, with a specificity and sensitivity of 83.3% and 88.2%, respectively. Conclusion Hypofractionated RT with fraction size of 3.5 Gy for early glottic cancer is effective. The hypopharyngeal mean dose could predict the occurrence of grade ≥2 acute mucositis. The posterior commissure can be safely excluded from the CTV.
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Affiliation(s)
- Tae Hoon Lee
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea
| | - Joo Ho Lee
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea
| | - Seong Keun Kwon
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea
| | - Eun-Jae Chung
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul, Korea
| | - Hong-Gyun Wu
- Department of Radiation Oncology, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
- Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Korea
- Correspondence: Hong-Gyun Wu Department of Radiation Oncology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea. Tel: +82-2-2072-3177 E-mail:
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Benson R, Giridhar P, Mallick S. Moderate hypofractionation for early laryngeal cancer improves local control with increased risk of mucositis: clarification. Eur Arch Otorhinolaryngol 2020; 277:2945. [PMID: 32748186 DOI: 10.1007/s00405-020-06257-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 07/27/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Rony Benson
- Department of Medical Oncology, Regional Cancer Centre, Trivandrum, India
| | - Prashanth Giridhar
- Department of Radiation Oncology, National Cancer Institute, All India Institute of Medical Sciences, Badsa, India
| | - Supriya Mallick
- Department of Radiation Oncology, National Cancer Institute, All India Institute of Medical Sciences, Badsa, India.
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Luo MS. Moderate hypofractionation for early laryngeal cancer improves local control. Eur Arch Otorhinolaryngol 2020; 277:2943-2944. [PMID: 32474649 DOI: 10.1007/s00405-020-06082-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 05/21/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Meng-Si Luo
- Department of Anesthesiology, Zhongshan Hospital of Traditional Chinese Medicine, Affiliated to Guangzhou University of Chinese Medicine, 3 Kangxin Road, Zhongshan, 528400, Guangdong, China.
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