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 [...]

2016-02-23T12:17:36-07:00February, 2016|Oral Cancer News|

Palliation Trumps PET in Prolonging Head and Neck Cancer Survival

Source: Elsevier Global Medical News. 2012 Feb 23, D McNamara MIAMI BEACH (EGMN) - Using PET scans to diagnose distant metastasis in patients with advanced head and neck squamous cell carcinoma does not significantly prolong life expectancy, compared with other imaging techniques, according to a retrospective study. Palliative chemotherapy did make a difference, however, significantly increasing life expectancy by 215 days in patients who received it, Dr. Matthew E. Spector and colleagues from the University of Michigan, Ann Arbor, reported at a meeting of the Triological Society. "Over 90% of patients at University of Michigan have at least one PET scan at some point in their treatment," Dr. Spector said. Increased sensitivity is one reason for such widespread adoption of the imaging technique. "We were wondering, while it may be more sensitive to identify distant metastatic disease, was it changing what we were doing?" In a retrospective look at 170 patients with such cancers at their institution, researchers found no significant difference in median survival between patients who had a PET scan (168 days) and those who did not (193 days). Determination of any survival difference was a primary aim of the study. "A lot of studies have looked at PET scans, and we know in up to one-third of cases it may change our decisions," Dr. Spector said. For example, a negative PET scan might mean definitive treatment, whereas a positive PET finding might lead to palliative therapy. However, "no one has looked at the impact of the PET findings on the life expectancy after diagnosis." All patients in the study had a distant metastasis diagnosis. "We found PET was more [...]

2012-02-27T11:42:48-07:00February, 2012|Oral Cancer News|
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