Head and neck carcinoma in the United States

Abstract

BACKGROUND: Detailed information about how patients with head and neckcarcinoma (HNC) are treated across practice settings does not exist. Theauthors conducted a prospective, observational study to examine thepatterns of care for a series of patients with newly diagnosed HNC inthe United States and to test 2 hypotheses: 1) There is no difference inthe pattern of care between community and academic settings; and 2) theresults of major randomized clinical trials will change the pattern ofcare in both practice settings within 1 year of publication inpeer-reviewed journals. METHODS: Patients aged =18 years were enrolledin the Longitudinal Oncology Registry of Head and Neck Carcinoma(LORHAN) after providing written informed consent if they had aconfirmed diagnosis of new HNC and were scheduled to receive treatmentother than surgery alone. RESULTS: Between 2005 and 2010, 100 centersenrolled 4243 patients, including 2612 patients (62%) from academicinvestigators and 1631 patients (38%) from community centers. Initialtreatments were radiation with concurrent chemotherapy (30%) orcetuximab (9%), adjuvant radiotherapy (21%), induction chemotherapy(16%), and other (24%). Intensity modulated radiation therapy was thedominant radiation technique (84%). Single-agent cisplatin wasprescribed in nearly half of patients and more often in academic centers(53% vs 43% of patients; P < .0001). Single-agent cetuximab was thenext most common drug used (19%) and was prescribed more frequently incommunity settings (24% vs 17%; P = .0001). The data rejected the 2prospective hypotheses. CONCLUSIONS: LORHAN documented differences inpatient characteristics and treatments between community and academicsettings for a large series of patients in the United States. Cancer2012. (c) 2012 American Cancer Society.