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Oncologic treatment landscape for head and neck squamous cell carcinoma

Treatment infrastructure in German-speaking countries

Onkologische Behandlungslandschaft für Plattenepithelkarzinome im Kopf-Hals-Bereich

Behandlungsstruktur in deutschsprachigen Ländern

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Abstract

Background

The treatment of head and neck squamous cell carcinoma (HNSCC) is highly complex and requires a multimodal approach. However, guidelines for the treatment of most forms of HNSCC do not exist in German-speaking countries with the exception of oral cavity cancer. The aim of this cross-sectional study was to describe the current treatment landscape and infrastructure in German-speaking countries.

Methods

From November 2013 to July 2014, 204 departments of otorhinolaryngology (ORL) in Germany, Austria, and the German-speaking part of Switzerland were contacted and invited to take part in a web-based survey on the treatment of HNSCC. In order to cover the study in its entirety, we published three consecutive papers of which this paper is the first.

Results

In all, 62 treatment centers (30.4 %) participated in the survey. These centers included 21 university hospitals, 16 certified cancer centers, and 35 large centers, which diagnose at least 75 HNSCC patients annually. In 91.9 % of all cases, there were outpatient consultation hours (that were monodisciplinary in 61.4 %). A multidisciplinary tumor board was existent in 98.4 % of the cases. Of 62 ORL departments, 50 had a hospital cancer registry, 41 of 62 conducted oncological studies, and 35 of 62 assessed their patients’ quality of life.

Conclusion

The infrastructure of the treatment for HNSCC can be considered mostly well-developed and supports interdisciplinary cooperation. Potential improvements can be made regarding the standardization of tumor boards, the participation in clinical trials, and the availability of cancer registries and the data gathered therein.

Zusammenfassung

Hintergrund

Die Behandlung von Plattenepithelzellkarzinomen im Kopf-Hals-Bereich (HNSCC) ist hochkomplex und erfordert häufig einen multimodalen Therapieansatz. Neben der operativen Therapie und Bestrahlung stehen auch konkurrierende systemische Therapiekonzepte wie die antineoplastische Chemotherapie zur Verfügung. Trotz der Komplexität der Behandlung fehlen, mit Ausnahme der Leitlinie zur Behandlung von Mundhöhlenkarziomen, einheitliche Leitlinien. Das Ziel dieser Querschnittsuntersuchung war, die derzeitige Behandlungslandschaft und Infrastruktur im deutschsprachigen Raum darzustellen.

Material und Methoden

Von November 2013 bis Juli 2014 wurden 204 HNO-Kliniken in Deutschland, Österreich und der deutschsprachigen Schweiz kontaktiert und zur Teilnahme an einer webbasierten Umfrage zur Tumortherapie von HNSCC aufgefordert.

Ergebnisse

Von 204 HNO-Kliniken partizipierten 62 (30,4 %). Unter diesen 62 Behandlungszentren sind 21 Universitätskliniken, 16 zertifizierte Krebszentren und 35 große Zentren, die jährlich mindestens 75 Patienten mit Erstdiagnose eines Plattenepithelzellkarzinoms des Larynx, Pharynx oder der Mundhöhle diagnostizieren. In 57/62 HNO-Kliniken gibt es eine Tumorsprechstunde, die in 35/57 Fällen monodisziplinär ist. Ein multidisziplinäres Tumorboard existiert in 61/62 Kliniken. 50/62 HNO-Kliniken haben ein klinisches Krebsregister, und die Zusatzbezeichnung medikamentöse Tumortherapie ist in 23/62 Kliniken vorhanden. Onkologische Studien werden in 41/62 und die Erhebung der Lebensqualität in 35/62 Behandlungszentren durchgeführt.

Schlussfolgerung

Die Umfrage ergab, dass die Infrastruktur für die Behandlung von HNSCC in vielen Bereichen gut entwickelt ist und eine interdisziplinäre Kooperation unterstützt. Verbesserungspotenzial gibt es bei der Standardisierung von Tumorboards, der Teilnahme an klinischen Studien sowie der Verfügbarkeit von Krebsregistern und daraus erhobener Daten.

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Acknowledgements

We greatly appreciate the time spent by all participating treatment centers for the completion of our survey and want to thank them for their detailed responses.

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Authors and Affiliations

  1. Department of Oto-Rhino-Laryngology and Head & Neck Surgery, Head & Neck Cancer Center Ulm, University Medical Center Ulm, Frauensteige 12, 89070, Ulm, Germany

    J. Kimmeyer, T. K. Hoffmann, J. A. Veit &  S. Laban

  2. Department of Oto-Rhino-Laryngology and Head & Neck Surgery, Head & Neck Cancer Center of the University Cancer Center Hamburg, University Medical Center Hamburg, Hamburg, Germany

    T. Kurzweg, R. Knecht, N. Möckelmann & A. Münscher

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  1. J. Kimmeyer
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Correspondence to S. Laban.

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Conflict of interest

R. Knecht is a member of the scientific advisory board for Merck Serono, Sanofi Aventis, Boehringer Ingelheim, and Bayer Healthcare Leverkusen. J. Kimmeyer, T. Kurzweg, T. K. Hoffmann, J. A. Veit, N. Möckelmann, A. Münscher, and S. Laban state that there are no conflicts of interest.

The accompanying manuscript does not include studies on humans or animals.

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Dieser Beitrag ist als eine Originalarbeit anzusehen und aus formalen Gründen im Leitthema dieser Ausgabe eingeordnet.

This article should be considered an original contribution and has been classified for technical reasons as a main topic.

J. Kimmey and T. Kurzweg contributed equally to this work and share first authorship.

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Kimmeyer, J., Kurzweg, T., Hoffmann, T.K. et al. Oncologic treatment landscape for head and neck squamous cell carcinoma. HNO 64, 494–500 (2016). https://doi.org/10.1007/s00106-016-0188-9

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  • DOI: https://doi.org/10.1007/s00106-016-0188-9

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