Japanese Clinical Practice Guideline for Head and Neck Cancer.
OBJECTIVE
The first revision of "Japanese Clinical Practice Guideline for Head and Neck Cancer" was made in 2013 by the clinical practice guideline committee of Japan Society for Head and Neck Cancer, in response to the revision of the TNM classification.


METHODS
34 CQs (Clinical Questions) were newly adopted to describe the diagnosis and treatment methods currently considered most appropriate, and offered recommendation grade made by the consensus of the committee. A comprehensive literature search was performed for studies published between 2001 and 2012 using PubMed. Qualified studies were analyzed and the results were evaluated, consolidated and codified by all the committee members.


RESULTS
Elective neck dissection (ND) does contribute to improvement in survival and should be performed for patients with high-risk tongue cancer. At present, no research has clearly demonstrated the utility of superselective arterial infusion chemotherapy. However, depending on the site and stage of the cancer, combination with radiotherapy may be useful for preserving organ function or improving survival rate. Concurrent CDDP chemotherapy and adjuvant radiotherapy contributes to improvement of survival rate as an adjuvant therapy for advanced squamous cell carcinoma of the head and neck in patients at high risk of recurrence. The anti-EGFR antibody cetuximab (Cmab) has an additive effect with radiotherapy. However, the indication must be carefully considered since this treatment has not been compared with the standard treatment of chemoradiotherapy. Cmab has been shown to have an additive effect with chemotherapy (CDDP/5-FU) in patients with unresectable metastatic or recurrent cancer. Preoperative and postoperative oral care may reduce the risk of postoperative complications such as surgical wound infection and pneumonia in head and neck cancers. Rehabilitation soon after ND for cervical lymph node metastasis is recommended for maintaining and restoring shoulder function.


CONCLUSIONS
In this article, we described most relevant guidelines and CQs for the diagnosis and treatment of head and neck cancer in Japan. These guidelines are not intended to govern therapies that are not shown here, but rather aim to be used as a guide in searching for the most appropriate treatment for individual patient.
Department of Otolarygology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Japan. Electronic address: nibu@med.kobe-u.ac.jp.
Ken-Ichi
KI
Nibu
Department of Head and Neck Surgery, National Cancer Center Hospital East, Japan.
Ryuichi
R
Hayashi
Department of Head and Neck Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Japan.
Takahiro
T
Asakage
Department of Radiology, Jikei University School of Medicine, Japan.
Hiroya
H
Ojiri
Department of Plastic and Reconstructive Surgery, Okayama University Graduate School of Medicine and Dentistry, Japan.
Yoshihiro
Y
Kimata
Department of Radiation Oncology, Aichi Cancer Center Hospital, Japan.
Takeshi
T
Kodaira
Department of Anatomic Pathology, Tokyo Medical University, Japan.
Toshitaka
T
Nagao
Department of Otolaryngology, Kyushu Medical Center, Japan.
Torahiko
T
Nakashima
Department of Otolaryngology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Japan.
Takashi
T
Fujii
Department of Clinical Oncology, Jichi Medical University, Japan.
Hirofumi
H
Fujii
Department of Otolaryngology-Head and Neck Surgery, Hokkaido University Graduate School of Medicine, Japan.
Akihiro
A
Homma
Department of Head and Neck Surgery, Miyagi Cancer Center, Japan.
Kazuto
K
Matsuura
Department of Head and Neck Surgery, Shikoku Cancer Center, Japan.
Nobuya
N
Monden
Division of Head and Neck Surgery, Saitama Cancer Center, Japan.
Takeshi
T
Beppu
Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Japan.
Nobuhiro
N
Hanai
Department of Oral and Maxillofacial Surgery, Nara Medical University, Japan.
Tadaaki
T
Kirita
Department of Plastic and reconstructive Surgery, Nagoya University Graduate School of Medicine, Japan.
Yuzuru
Y
Kamei
Department of Medical Oncology/Hematology, Kobe University Hospital, Japan.
Naoki
N
Otsuki
Department of Radiation Oncology, National Cancer Center Hospital East, Japan.
Naomi
N
Kiyota
Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Tokyo Medical and Dental University, Japan.
Sadamoto
S
Zenda
Department of Otolaryngology-Head and Neck Surgery, Kyoto University Graduate School of Medicine, Japan.
Ken
K
Omura
Department of Radiation Oncology, National Cancer Center Hospital East, Japan.
Koichi
K
Omori
Department of Head and Neck Oncology, Japanese Foundation for Cancer Research, Cancer Institute Hospital, Japan.
Tetsuo
T
Akimoto
Department of Head and Neck Surgery, Kameda General Center, Japan.
Kazuyoshi
K
Kawabata
Department of Otolaryngology-Head and Neck Surgery, Tottori University Graduate School of Medicine, Japan.
Seiji
S
Kishimoto
Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Japan.
Hiroya
H
Kitano
Department of Plastic, Reconstructive and Aesthetic Surgery, Saitama Medical University, Japan.
Iwai
I
Tohnai
Department of Otolaryngology, Kyushu Medical Center, Japan.
Takashi
T
Nakatsuka
D006801:Humans; D000074322:Antineoplastic Agents, Immunological / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000628:therapy; D000068818:Cetuximab / Q000627:therapeutic use; D059248:Chemoradiotherapy / Q000379:methods; D006258:Head and Neck Neoplasms / Q000628:therapy; D007564:Japan; D037981:Neck Dissection / Q000379:methods; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods; D011878:Radiotherapy / Q000379:methods; D000077195:Squamous Cell Carcinoma of Head and Neck
D000074322:Antineoplastic Agents, Immunological; D000068818:Cetuximab
Clinical practice guideline; Clinical question; Head and neck cancer