title: Head and neck carcinoma in the United States: first comprehensive report of the Longitudinal Oncology Registry of Head and Neck Carcinoma (LORHAN).
abstract: BACKGROUND
  Detailed information about how patients with head and neck carcinoma (HNC) are treated across practice settings does not exist. The authors conducted a prospective, observational study to examine the patterns of care for a series of patients with newly diagnosed HNC in the United States and to test 2 hypotheses: 1) There is no difference in the pattern of care between community and academic settings; and 2) the results of major randomized clinical trials will change the pattern of care in both practice settings within 1 year of publication in peer-reviewed journals.
  
  
  METHODS
  Patients aged ≥ 18 years were enrolled in the Longitudinal Oncology Registry of Head and Neck Carcinoma (LORHAN) after providing written informed consent if they had a confirmed diagnosis of new HNC and were scheduled to receive treatment other than surgery alone.
  
  
  RESULTS
  Between 2005 and 2010, 100 centers enrolled 4243 patients, including 2612 patients (62%) from academic investigators and 1631 patients (38%) from community centers. Initial treatments were radiation with concurrent chemotherapy (30%) or cetuximab (9%), adjuvant radiotherapy (21%), induction chemotherapy (16%), and other (24%). Intensity modulated radiation therapy was the dominant radiation technique (84%). Single-agent cisplatin was prescribed in nearly half of patients and more often in academic centers (53% vs 43% of patients; P < .0001). Single-agent cetuximab was the next most common drug used (19%) and was prescribed more frequently in community settings (24% vs 17%; P = .0001). The data rejected the 2 prospective hypotheses.
  
  
  CONCLUSIONS
  LORHAN documented differences in patient characteristics and treatments between community and academic settings for a large series of patients in the United States.
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA. kianang@mdanderson.org
authors.forename: K Kian
authors.initials: KK
authors.lastname: Ang
authors.forename: Amy
authors.initials: A
authors.lastname: Chen
authors.forename: Walter J
authors.initials: WJ
authors.lastname: Curran
authors.forename: Adam S
authors.initials: AS
authors.lastname: Garden
authors.forename: Paul M
authors.initials: PM
authors.lastname: Harari
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Murphy
authors.forename: Stuart J
authors.initials: SJ
authors.lastname: Wong
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Bellm
authors.forename: Marc
authors.initials: M
authors.lastname: Schwartz
authors.forename: Jason
authors.initials: J
authors.lastname: Newman
authors.forename: Douglas
authors.initials: D
authors.lastname: Adkins
authors.forename: D Neil
authors.initials: DN
authors.lastname: Hayes
authors.forename: Upendra
authors.initials: U
authors.lastname: Parvathaneni
authors.forename: David
authors.initials: D
authors.lastname: Brachman
authors.forename: Bassam
authors.initials: B
authors.lastname: Ghabach
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Schneider
authors.forename: Michael
authors.initials: M
authors.lastname: Greenberg
authors.forename: Pramila R
authors.initials: PR
authors.lastname: Anné
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy; D002986:Clinical Trials as Topic; D005260:Female; D006258:Head and Neck Neoplasms / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012042:Registries; D014481:United States / Q000453:epidemiology