Squamous Cell Carcinoma of the Oral Cavity, Oropharynx, and Larynx: A Scoping Review of Treatment Guidelines Worldwide

Abstract

Head and neck cancer (HNC) treatments have been based on single or multimodal therapies with surgery, radiotherapy (RT), chemotherapy, and immunotherapy. However, treatment recommendations among countries may differ due to technological/human resources and usual local practices. This scoping review aims to identify, compare, and map the clinical practice guidelines (CPGs) for treating squamous cell carcinoma (SCC) of the oral cavity, oropharynx, and larynx worldwide. A search strategy on global CPGs for HNC was performed by using five electronic databases and grey literature. CPGs were selected for inclusion using EndNote-20 and Rayyan online software. No language or publication date restrictions were applied. The results were analyzed descriptively considering the most updated CPG version. In total, 25 CPGs covering the head and neck region (10), the larynx (7), the oral cavity (5), and the oropharynx (3), were found in 13 geographical regions, and 19 were developed by medical societies from 1996 to 2023. Surgery and RT remain the main modalities for early-stage HNC, with surgery preferred in low-resource countries, and RT in selected cases, especially in the larynx/oropharynx aiming to achieve a cure with organ preservation. Human papillomavirus infection for oropharyngeal SCC is not tested in some Asian countries and there is still no consensus to treat p16-positive cases differently from p16-negative. Recommendations for larynx preservation vary according to facilities in each country, however, individualized choice is emphasized. Inequality across countries/continents is evident, with a similar pattern of recommendations among developed as well as developing ones. No CPGs were found in Latin America as well as Oceania countries, where the incidence of HNC is high and limitations of access to treatment may be encountered.

Profiling of swallowing function in head and neck cancer patients prior to radiation therapy-Findings from a tertiary hospital in South India

“…Though in India, cancer of the lip and oral cavity are the most common subsites of cancer in men and the fourth most common cancer in women ( Sung et al, 2021 ), in the present study, only 16.7 % of the patients had cancer of this subsite while the majority had oropharyngeal cancer. This could be because of the inclusion criteria that excluded surgical patients, and most oral cavity cancers are treated with primary surgery due to the accessibility for resection ( Arboleda et al, 2023 Sep 3 , Chaturvedi et al, 2020 ).…”

Strategies for evidence-based in head and neck cancer: practical examples in developing systematic review questions

“…It this context, lifestyle is highlight as a major point. Different forms of tobacco use, including betel quid/areca nut, alcohol consumption, and human papillomavirus (HPV) infection are the most related risk factors (4). Tobacco and alcohol, whether separately or in combination, are mainly associated with oral SCC.…”

Targeting histone deacetylases in head and neck squamous cell carcinoma: molecular mechanisms and therapeutic targets

“…Therapeutic interventions for HNSCC encompass surgery, radiotherapy (RT), chemotherapy and immunotherapy, with the choice guided by the TNM classification system as delineated by the Union for International Cancer Control/American Joint Committee on Cancer [4]. Innovative treatment modalities, such as laser surgery, photodynamic therapy and sonodynamic therapy, have made some progress in reducing morbidity and improving patient quality of life [5][6][7]. Nonetheless, the therapeutic efficacy of HNSCC management is still restricted.…”