Re-irradiation of Recurrent or Second Primary Head and Neck Cancer After Prior Radiation: Initial Findings of an American Radium SocietyTM (ARS) Appropriate Use Criteria Systematic Review

Document Type

Conference Proceeding

Publication Date

10-1-2021

Publication Title

Cancer Clin Trials

Abstract

Background: In 2011, the Appropriateness Criteria for Retreatment of Recurrent Head and Neck Cancer After Prior Definitive Radiation were published. The American Radium Society (ARS) Appropriate Use Criteria (AUC) committee performed an updated literature review in 2021. Objectives: Update the literature review to prepare for the upcoming AUC. Methods: The ARS convened a multidisciplinary expert panel composed of radiation, medical and surgical oncologists. A search of the medical literature was conducted using subject-specific keywords in PubMed, Embase and Scopus databases. Five key questions were approved by the committee. Screening identified articles containing original data published from January 2000-December 2020 in the English language. Articles were removed if they focused on salvage therapies other than re-irradiation or were not otherwise relevant to one of the key questions. The final data tables contained the details of all systematic reviews, meta-analyses, and prospective randomized trials and the highest level of evidence available for each key question. Results: The key questions are listed in Table 1. From the initial search, 686 citations were identified, of which 231 were duplicates. An additional 8 citations were identified through other sources. Of the resulting 463 abstracts, 189 were excluded because they were review manuscripts (N = 66) or because the primary subject focused on the initial course of therapy (N= 43), were in non-English language (N = 23), or were published before 2000 (N = 23). In total, 274 manuscripts informed the panel discussion, of which 9 were systematic reviews/meta-analyses, 5 were prospective randomized trials, 28 were single-arm prospective studies, 15 were multi-institution retrospective studies, 188 were single-institution retrospective studies and 29 were original manuscripts of other types (models, case reports, etc.). Table 2 presents the 30 studies identified by type, with those included in the detailed data table shaded (a single study may be included in multiple cells). Conclusions: The AUC head and neck committee completed a literature search intended to update the original reirradiation publication in 2011. This updated literature review will inform the forthcoming updated AUC. (Figure Presented).

Volume

44

Issue

10

First Page

S89

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