NCCN Is ‘Vague,’ So Study Clarifies H&N Cancer Follow-up
Source: www.medscape.comAuthor: Nick Mulcahy Clinical guidelines can sometimes be slow to respond to epidemiology. Take the case of oropharyngeal cancers that are associated with human papillomavirus (HPV) infection. They are increasingly common in the United States and, as several studies have demonstrated, have better survival than cancers of this type that are not HPV-positive. Nonetheless, one of the beacons in oncology care, the National Comprehensive Cancer Network (NCCN), recommends the same follow-up care guidance for oropharynx squamous cell carcinoma whether it is associated with HPV or not, according to two experts. For post-treatment follow-up, including recurrence detection, "the NCCN guidelines are one-size-fits-all," said Jessica Frakes, MD, a radiation oncologist at the Moffitt Cancer Center and Research Institute in Tampa, Florida. She spoke during a press briefing at the Multidisciplinary Head and Neck Cancer Symposium 2016 in Scottsdale, Arizona. "You are exactly right: the NCCN is fairly vague about when to perform imaging," said Christine Gourin, MD, an otolaryngologist at Johns Hopkins University in Baltimore, who moderated the press briefing. Dr Frakes and her colleagues have stepped into this informational breach with a new study that might help clinicians gain clarity on the use of surveillance imaging in HPV-positive oropharyngeal cancer and reduce its frequency. "The purpose of our study is to determine when these patients fail and when they have side effects so we know how to guide optimal follow-up," Dr Frakes explained. The study authors examined 246 cases of nonmetastatic HPV-positive oropharynx squamous cell carcinoma treated with radiation therapy at [...]