[Recommendation for guidelines in the treatment of squamous cell cancer of the upper aerodigestive tract].
If we look at the historical development of the treatment of head and neck cancer, we can see that initially, decisions about therapy lay solely in the hands of the surgeons (Otorhinolaryngologists, oral and maxilla-facial surgeons) This was also true of the decision as to whether an operation was feasible or whether primary radio therapy was to be carried out. At the end of the last century, after chemotherapy had become an integral part of curative therapy, inter-disciplinary conferences (tumour boards) were set up so that the surgeons could make joint decisions about therapy together with radio oncologists and medical oncologists. In addition, the increasingly important role of chemotherapy in curative therapy in the last fifteen years has led to a marked increase in the number of clinical studies in head and neck cancer. Inter-disciplinary treatment decisions can be based only on current scientific knowledge and are geared towards a standard treatment as recommended for an individual tumour stage. It is precisely in the upper aerodigestive tract that there are various therapeutical procedures, due to the different site of primaries (oral cavity, oro-, hypoparynx and larynx) and the different grade of locoregional metastasis. One possible way to assure a high degree of transparency of these various therapies and making them available to a high number of colleagues is the development guidelines [1]. Many medical associations and organisations in Austria are currently engaged in the formulation and definition of guidelines, in order to provide the highest possible quality of medical treatment and care for each individual patient. By guidelines are meant recommendations for treatments which allow a certain amount of flexibility in the treatment and provide a medical consensus in line with current scientific knowledge. In principle, they are binding, but in exceptional but reasonable cases, they may (and even must) be departed from. The following proposal is designed to provide a basis for the formulation of guidelines for the treatment of head and neck cancer in Austria. It was put together with help from ENT specialists, medical oncologists and radio oncologists from across Austria. One advantage was certainly the fact that several foreign associations had already drawn up guidelines which could be referred to [2, 3]. Since guidelines are dynamic in nature and must be constantly adapted to correspond to current medical knowledge and research, they are often only available today on websites. For this reason, links to relevant sites are given at the end of this article.
Klinische Abteilung für Allgemeine Hals-Nasen-Ohrenkrankheiten, Universitätsklinik für Hals-Nasen-Ohrenkrankheiten, Medizinische Universität Wien, Wien, Austria. martin.burian@meduniwien.ac.at
Martin
M
Burian
D000465:Algorithms; D001317:Austria; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy*; D003299:Cooperative Behavior; D006801:Humans; D009367:Neoplasm Staging; D010039:Otorhinolaryngologic Neoplasms / Q000473:pathology / Q000628:therapy*; D010348:Patient Care Team; D017410:Practice Guidelines as Topic