Patterns of care in de-novo oligo-metastatic and oligo-recurrent head and neck cancers: A Head and Neck Cancer International Group (HNCIG) Survey.

BACKGROUND

The current survey was conducted among head and neck cancer physicians across the globe to understand the patterns of care and practice for de-novo oligo-metastatic (OM) and oligo-recurrent (OR) head and neck cancer (HNC).

MATERIAL AND

METHODS

An 18-item survey questionnaire was designed and distributed through the member organizations of the Young Investigator Subcommittee of the HNCIG. The responses were presented as a proportion of the total response for a particular survey item.

RESULTS

A total of 204 responses were obtained with an overall response rate of 15.6 % (204/1307). The incidence of OM disease was reported to be < 10 % by 81.9 % of respondents with a higher incidence of oligo-recurrent disease (up to 20 %). Performance status and extent of disease are absolute essential factors for decision-making. In suitable patients, the majority of respondents (67.4 %) would like to treat with a combination of systemic and local therapy both to primary and metastatic site. For oligo-recurrent HNC, 63.7 % of respondents would treat with both systemic and metastatic directed therapy (MDT) with 27 % would consider MDT alone. Surgery and stereotactic body radiotherapy (SBRT) remain the choice of MDT for lung and liver metastasis. The majority of the respondents use SBRT in > 50 % of their patients.

CONCLUSION

The current approach to de-novo OM and oligo-recurrent HNC varies in this global survey, but a significant proportion of respondents support radical intent treatment in select cases. Multicentre retrospective and prospective studies as well as international consensus statement are essential prerequisites for developing future clinical guidelines.