Prospective Evaluation of Patient Priorities in HPV-Driven Oropharyngeal Cancer Using the Chicago Priorities Scale: Considerations for Future Clinical Trial Design.

Purpose: This study examined head and neck cancer treatment outcome priorities in patients with human papillomavirus-associated oropharyngeal cancer (HPVOPC) before and 12 months (12m) after (chemo)radiotherapy ([C]RT).

Methods And Materials: Eligible patients were diagnosed with HPVOPC suitable for curative-intent primary [C]RT. Study data included responses to a modified version of the Chicago Priorities Scale (CPS-modified) and select items from the MDASI Head and Neck Cancer Module (MDASI-HN).

Target volume delineation of the neck for radiotherapy in nasopharyngeal carcinoma: CSTRO, CACA, CSCO, HNCIG, ESTRO, and ASTRO guidelines and contouring atlas.

The Chinese Society for Therapeutic Radiology Oncology, the Chinese Anti-Cancer Association, the Chinese Society of Clinical Oncology, the Head and Neck Cancer International Group, the European Society for Radiotherapy and Oncology, and the American Society for Radiation Oncology collaboratively developed evidence-based guidelines and a comprehensive contouring atlas for neck target volume delineation in nasopharyngeal carcinoma. These guidelines address five key challenges in modern radiotherapy practice: margin design of clinical target volume; nodal target volume delineation after induction chemotherapy; delineation of equivocal nodes evident on imaging; low-risk clinical target volume delineation based on regional stepwise extension patterns; and modifications for anatomical boundaries of lymphatic areas. Developed through a rigorous systematic review and expert appraisal process by a panel of 50 international, multidisciplinary members from 17 countries and regions, these guidelines incorporate the latest advances in nasopharyngeal carcinoma diagnosis and treatment.

Primary target volume delineation for radiotherapy in nasopharyngeal carcinoma: CSTRO, CACA, CSCO, HNCIG, ESTRO, and ASTRO guidelines and contouring atlas.

The Chinese Society for Therapeutic Radiology Oncology, the Chinese Anti-Cancer Association, the Chinese Society of Clinical Oncology, Head and Neck Cancer International Group, the European Society for Radiotherapy and Oncology, and the American Society for Radiation Oncology jointly developed evidence-based guidelines and a contouring atlas for primary target volume delineation for radiotherapy in nasopharyngeal carcinoma. The guidelines systematically address three crucial challenges: margin design of clinical target volumes; target volume delineation after induction chemotherapy; and low-risk clinical target volume delineation based on local stepwise extension patterns. Based on a comprehensive systematic review and critical appraisal by an international multidisciplinary panel of 50 nasopharyngeal carcinoma specialists from 17 countries and regions, these guidelines are in keeping with advances in nasopharyngeal carcinoma diagnosis and treatment, embodying contemporary treatment concepts, and elaborating on the differences in practice.

Chemoradiotherapy vs Radiotherapy Alone in T1-2 Oropharyngeal Cancer with Low Volume Neck Disease: A Population-Based Cohort Study Utilizing the XXXXX Head and Neck Cancer Register.

Purpose: The benefit of adding concurrent systemic therapy to definitive radiotherapy (RT) for patients with T1-2 oropharyngeal squamous cell carcinoma (OPSCC) and limited neck node involvement is uncertain. This study investigates if chemoradiotherapy (CRT) in patients with early-stage (T1-2) low-volume nodal disease (UICC7 N1-2b) improves overall survival (OS) compared to RT alone.

Methods: A cohort study with data from the prospective XxxxHead and Neck Cancer Register, leveraging variation of receiving CRT based on healthcare region.

Multidisciplinary Care of Locally Advanced Mucosal Head and Neck Cancer: An Australian Perspective.

Locally advanced mucosal head and neck squamous cell carcinoma (LA-HNSCC) is associated with several key risk factors including smoking, alcohol, and human papillomavirus (HPV) infection. Unfortunately, the current treatment modalities for LA-HNSCC, which can include combinations of surgery, radiotherapy, and systemic therapy, may result in substantial treatment-related toxicity and functional consequences for patients with a significant impact on quality of life. Due to the complex nature of the disease and acute and delayed treatment-related morbidity, treatment of LA-HNSCC requires a multidisciplinary approach that is optimally funded and accessible for patients regardless of geography.

Accuracy and Prognosis of Extranodal Extension on Radiologic Imaging in Human Papillomavirus-Mediated Oropharyngeal Cancer: A Head and Neck Cancer International Group (HNCIG) Real-world Study.

Purpose: Extranodal extension on radiology (iENE) is reported in single-center studies to be negatively prognostic in human papillomavirus-mediated oropharyngeal cancer (HPV + OPC) and is a major eligibility criterion for surgical treatment. However, studies report widely varying sensitivities, specificities, and interobserver correlation. In this research the prognostic power, sensitivity, and specificity of iENE in HPV + OPC in real-world practice are determined.

Final Results From a Longitudinal Observation Study Evaluating Sexual Health and Facial Appearance and Distress in Human Papillomavirus-Associated Oropharyngeal Cancer Survivors Treated With Chemoradiotherapy.

Purpose: This communication reports on the complete results of a prospective study evaluating sexual health and appearance-related outcomes in human papillomavirus-associated oropharyngeal cancer (HPVOPC) survivors treated with (chemo)radiation therapy ((C)RT).

Methods And Materials: One hundred patients with HPVOPC scheduled to receive curative-intent (C)RT were enrolled into a longitudinal observational study between October 2020 and November 2021. Sexual health was measured using the 22-item European Organisation for Research and Treatment of Cancer (EORTC) Sexual Health Questionnaire and appearance-related issues were measured using FACE-Q Appearance and Appearance distress modules.

Feasibility and Acceptability of the Fear-Less Screening and Stratified-Care Model for Fear of Cancer Recurrence Among People Affected by Early-Stage Cancer.

Objectives: Fear of cancer recurrence (FCR) is a prevalent unmet need for people affected by cancer, in the context of limited healthcare resources. Stratified-care models have potential to meet this need, while reducing resource demands. This study aimed to evaluate the feasibility and acceptability of screening procedures and interventions within the Fear-Less stratified-care model among those impacted by early-stage cancer.

Determinants of Prognosis in Head and Neck Cutaneous Squamous Cell Carcinoma With Nodal Metastases.

Importance: The eighth edition tumor, node, metastasis (TNM) staging for head and neck cutaneous squamous cell carcinoma (HNcSCC) is a poor predictor of survival in patients with lymph node metastases, possibly due to the inclusion of extranodal extension (ENE).

Objective: To identify the key determinants of prognosis in patients with nodal metastatic HNcSCC and analyze the association of ENE with TNM stage and investigate for prognostic heterogeneity in ENE-positive disease.

Design, Setting, And Participants: This retrospective, multicenter cohort study was conducted at 4 Australian tertiary referral centers using prospectively collected data in patients treated between 1980 and 2017 with a median (IQR) follow-up of 3.

Early return to work is possible after transoral robotic surgery (TORS) in carefully selected patients with oropharyngeal squamous cell carcinoma.

Introduction: The aims of this study were to investigate the rate and time to return to work (RTW) after transoral robotic surgery (TORS) for oropharyngeal squamous cell carcinoma (OPSCC) and to explore the impact of disease or work-related factors leading to variations in RTW outcomes.

Methods: Cross-sectional survey of disease, socioeconomic, work-related and health-related quality of life (HR-QOL). Qualitative analysis of responses for facilitators and barriers to RTW.

Predictors of distant metastatic recurrence in head and neck cutaneous squamous cell carcinoma with lymph node metastases treated with curative intent: A multicenter study.

Background: We aimed to identify predictors of distant metastatic recurrence (DMR) in patients with head and neck cutaneous squamous cell carcinoma (HNcSCC) with nodal metastases treated with curative intent.

Methods: Predictors of DMR were identified using Cox regression in a multicenter study of 1151 patients.

Results: The 5-year risk of DMR was 9.

Sexual Health, sexuality and sexual intimacy in patients with head and neck cancer - A narrative review.

Sexuality and sexual intimacy are important aspects of cancer survivorship. In head and neck cancer (HNC), concerns around sexual health, sexuality and sexual intimacy are infrequently raised or addressed in standard HNC consultations, either before embarking on treatment or during survivorship. The changing demographic of HNC patients, largely due to the increasing proportion of patients with human papillomavirus-associated oropharyngeal squamous cell carcinoma (HPVOPSCC), has driven renewed interest in some specific survivorship issues, including sexual behaviours and lifestyles, which may account for both the primary mode of HPV transmission and the younger and less comorbid population affected by this disease.

Assessment of endpoint definitions in recurrent and metastatic mucosal head and neck squamous cell carcinoma trials: Head and Neck Cancer International Group consensus recommendations.

Transparent and precise endpoint definitions are a crucial aspect of clinical trial conduct and reporting, and are used to communicate the benefit of an intervention. Previous studies have identified inconsistencies in endpoint definitions across oncological clinical trials. Here, the Head and Neck Cancer International Group assessed endpoint definitions from phase 3 trials or trials considered practice-changing for patients with recurrent or metastatic mucosal head and neck squamous cell carcinoma, published between 2008 and 2021.

Criteria for the diagnosis of extranodal extension detected on radiological imaging in head and neck cancer: Head and Neck Cancer International Group consensus recommendations.

Extranodal extension of tumour on histopathology is known to be a negative prognostic factor in head and neck cancer. Compelling evidence suggests that extranodal extension detected on radiological imaging is also a negative prognostic factor. Furthermore, if imaging detected extranodal extension could be identified reliably before the start of treatment, it could be used to guide treatment selection, as patients might be better managed with non-surgical approaches to avoid the toxicity and cost of trimodality therapy (surgery, chemotherapy, and radiotherapy together).

A Hard Truth to Swallow: Critically Evaluating the MD Anderson Dysphagia Inventory (MDADI) as an Endpoint in Human Papillomavirus-associated Oropharyngeal Cancer Trials.

The MD Anderson Dysphagia Inventory (MDADI), a measure of swallowing-related quality of life, has become the preferred patient-reported outcome measure (PROM) in contemporary clinical trials evaluating the experience of human papillomavirus-associated oropharyngeal squamous cell carcinoma (HPVOPSCC) survivors. With many potentially practice-changing studies using the MDADI composite score as either a primary or coprimary endpoint, or as a key secondary endpoint, it is important to understand its psychometric properties as judged by contemporary PROM standards, with a particular focus on its application to contemporary HPVOPSCC populations. In this critical review, we evaluate contemporary HPVOPSCC studies reporting MDADI outcomes, followed by a detailed evaluation of the psychometric properties of the MDADI.

Essential data variables for a minimum dataset for head and neck cancer trials and clinical research: HNCIG consensus recommendations and database.

The Head and Neck Cancer International Group (HNCIG) has undertaken an international modified Delphi process to reach consensus on the essential data variables to be included in a minimum database for HNC research. Endorsed by 19 research organisations representing 34 countries, these recommendations provide the framework to facilitate and harmonise data collection and sharing for HNC research. These variables have also been incorporated into a ready to use downloadable HNCIG minimum database, available from the HNCIG website.

Radiotherapy quality assurance in the TROG 12.01 randomised trial and its impact on loco-regional failure.

Introduction: There is no consensus as to what specifically constitutes head and neck cancer radiotherapy quality assurance (HNC RT QA). The aims of this study are to (1) describe the RT QA processes used in the TROG 12.01 study, (2) review the RT QA processes undertaken for all patients with loco-regional failure (LRF), and (3) provide prospective data to propose a consensus statement regarding the minimal components and optimal timing of HNC RT QA.

Combinatorial Approaches for Chemotherapies and Targeted Therapies With Radiation: United Efforts to Innovate in Patient Care.

Combinatorial therapies consisting of radiation therapy (RT) with systemic therapies, particularly chemotherapy and targeted therapies, have moved the needle to augment disease control across nearly all disease sites for locally advanced disease. Evaluating these important combinations to incorporate more potent therapies with RT will aid our understanding of toxicity and efficacy for patients. This article discusses multiple disease sites and includes a compilation of contributions from expert Red Journal editors from each disease site.