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. 2021 Jan;43(1):367-391.
doi: 10.1002/hed.26490. Epub 2020 Oct 23.

Systematic review of postoperative therapy for resected squamous cell carcinoma of the head and neck: Executive summary of the American Radium Society appropriate use criteria

Danielle N Margalit  1 , Assuntina G Sacco  2 , Jay S Cooper  3 , John A Ridge  4 , Richard L Bakst  5 , Beth M Beadle  6 , Jonathan J Beitler  7 , Steven S Chang  8 , Allen M Chen  9 , Tom J Galloway  4 , Shlomo A Koyfman  10 , Carol Mita  11 , Jared R Robbins  12 , C Jillian Tsai  13 , Minh T Truong  14 , Sue S Yom  15 , Farzan Siddiqui  8
Affiliations

Systematic review of postoperative therapy for resected squamous cell carcinoma of the head and neck: Executive summary of the American Radium Society appropriate use criteria

Danielle N Margalit et al. Head Neck. 2021 Jan.

Abstract

Background: The aims of this systematic review are to (a) evaluate the current literature on the impact of postoperative therapy for resected squamous cell carcinoma of the head and neck (SCCHN) on oncologic and non-oncologic outcomes and (b) identify the optimal evidence-based postoperative therapy recommendations for commonly encountered clinical scenarios.

Methods: An analysis of the medical literature from peer-reviewed journals was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline. Prospective studies and methodology-based systematic reviews and meta-analyses of postoperative therapy for SCCHN were identified by searching Medline (OVID) and EMBASE (Elsevier) using controlled vocabulary terms (ie, National Library of Medicine Medical Subject Headings [MeSH], EMTREE). Study screening and selection was performed with Covidence software and full-text review. The RAND/UCLA appropriateness method was used by the expert panel to rate the appropriate use of postoperative therapy, and the modified Delphi method was used to come to consensus.

Results: A total of 5660 studies were identified and screened using the title and abstract, leading to 201 studies assessed for relevance using full-text review. After limitation to the eligibility criteria, 101 studies from 1977 to 2020 were identified, including 77 with oncologic endpoints and 24 with function and quality of life endpoints. All studies reported staging prior to the implementation of American Joint Committee on Cancer (AJCC-8).

Conclusions: Prospective clinical studies and systematic reviews identified through the PRISMA systematic review provided good evidence for consensus statements regarding the appropriate use of postoperative therapy for resected SCCHN. Further research is needed in domains where consensus by the expert panel could not be achieved for the appropriateness of specific postoperative therapeutic interventions.

Keywords: adjuvant therapy; appropriate use; guidelines; head and neck cancer; postoperative.

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Conflict of interest statement

All panelists were required to declare all conflicts of interest for the previous 36 months prior to initiating work on this document. These complete disclosure forms are retained by the American Radium Society in perpetuity. The ARS Appropriate Use Criteria Steering Committee reviewed these disclosures with the chair and co‐chair of this document and approved participation of the panelists prior to starting development of this work. Disclosures potentially relevant to the content of this guideline are provided. Dr Bakst has nothing to disclose; Dr Beadle has nothing to disclose; Dr Beitler has nothing to disclose; Dr Chang has nothing to disclose; Dr Chen has nothing to disclose; Dr Cooper has nothing to disclose; Dr Galloway reports personal fees from Varian Medical Systems, personal fees from UpToDate Inc, outside the submitted work; Dr Koyfman reports grants from Merck, grants from Bristol Myers Squib, other from Varian Medical Systems, other from UpToDate, outside the submitted work; Dr Margalit reports personal fees from Galera Therapeutics in 2018, outside the submitted work; Dr Ridge has nothing to disclose; Dr Robbins has nothing to disclose; Dr Sacco reports other from Merck, outside the submitted work; Dr Siddiqui reports grants, personal fees and non‐financial support from Varian Medical Systems, Inc, other from American College of Radiology, other from Wayne State University School of Medicine, outside the submitted work; Dr Truong reports travel expenses from the American Board of Radiology and honoraria from the NCI PDQ Editorial Board; Dr Tsai reports consulting fees/honorarium from Varian; Dr Yom reports grants from Genentech, grants from Bristol‐Myers Squibb, grants from Merck, grants from BioMimetix, personal fees from Springer, personal fees from UpToDate, outside the submitted work.

Figures

FIGURE 1
FIGURE 1
Study selection QUOROM flow diagram
See this image and copyright information in PMC

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