PURPOSE The aim of the current work is to provide evidence-based recommendations to practicing physicians and others on the management of the neck in patients with squamous cell carcinoma of the oral cavity and oropharynx. METHODS ASCO convened an Expert Panel of medical oncology, surgery, radiation oncology, and advocacy experts to conduct a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 1990 through 2018. Outcomes of interest included survival, regional disease control, neck recurrence, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. RESULTS The literature search identified 124 relevant studies to inform the evidence base for this guideline. Six clinical scenarios were devised; three for oral cavity cancer and three for oropharynx cancer, and recommendations were generated for each one. RECOMMENDATIONS For oral cavity cancers, clinical scenarios focused on the indications for and the hallmarks of a high-quality neck dissection, indications for postoperative radiotherapy or chemoradiotherapy, and whether radiotherapy alone is sufficient elective treatment of an undissected neck compared with high-quality neck dissection. For oropharynx cancers, clinical scenarios focused on hallmarks of a high-quality neck dissection, factors that would favor operative versus nonoperative primary management, and clarifying criteria for an incomplete response to definitive chemoradiation for which salvage neck dissection would be recommended. Consensus was reached and recommendations were made for all six clinical scenarios. Additional information is available at www.asco.org/head-neck-cancer-guidelines .
Analog in-circuit program generator (APG) technology has improved to a state where the quality of tests written by APGs can hardly be met by tests written by humans [Crook 901. One of the best examples of high-quality APGs can be found in Hewlett-Packard's HP 3070 board tester.The primary reason why automatically generated tests are non-optimal is that the input to the APG, the data that describes the board under test, contains inaccuracies. It requires a long debug process to catch these inaccuracies. We propose a new debug methodology for tests, in which the root cause for tests that fail during debug is diagnosed and repaired.In order to aid the test developer and to cut debug time we have developed a debug environment that supports this methodology. An expert system, named ROSALIND, analyses the results of a debug testplan and is able to take additional measurements on the testhead in order to diagnose failing tests.A research prototype has been implemented and tested. It cuts diagnosis time, facilitates higher test qualities and makes the implementation of revision changes to the board under test much easier.
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