Harry Quon and Arlene Forastiere, Johns Hopkins University School of Medicine, Baltimore, MD; Neha Vapiwala, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Erin B. Kennedy, American Society of Clinical Oncology, Alexandria, VA; David J. Adelstein, Taussig Cancer Institute, Cleveland, OH; Holly Boykin, Head and Neck Cancer Alliance, Charleston, SC; Joseph A. Califano, University of California San Diego Medical Center, San Diego; F. Chris Holsinger, Stanford University Medical Center, Palo Alto, CA; Brian Nussenbaum, Washington University School of Medicine, St. Louis, MO; David I. Rosenthal, The University of Texas MD Anderson Cancer Center, Houston TX; and Lillian L. Siu and John N. Waldron, Princess Margaret Cancer Centre, Toronto, Canada.
J Clin Oncol. 2017 Dec 20;35(36):4078-4090. doi: 10.1200/JCO.2017.73.8633. Epub 2017 Oct 24.
Purpose The American Society for Radiation Oncology (ASTRO) produced an evidence-based guideline on radiation therapy in oropharyngeal squamous cell carcinoma (OPSCC) that was determined to be relevant to the American Society of Clinical Oncology (ASCO) membership. After applying standard critical appraisal policy and endorsement procedures, ASCO chose to endorse the ASTRO guideline. Methods The ASTRO guideline was reviewed by ASCO content experts for clinical accuracy and by ASCO methodologists for developmental rigor. On favorable review, an ASCO Expert Panel was convened to review the guideline contents and recommendations. The ASCO guideline approval body, the Clinical Practice Guidelines Committee, approved the final endorsement. Results The ASCO Expert Panel determined that the ASTRO guideline recommendations, published in July 2017, are clear, thorough, and based upon the most relevant scientific evidence. ASCO endorsed the ASTRO guideline and added minor qualifying statements. Recommendations Recommendations for the addition of systemic therapy to definitive radiotherapy in the treatment of OPSCC, postoperative radiotherapy with and without systemic therapy following primary surgery of OPSCC, induction chemotherapy in the treatment of OPSCC, and the appropriate dose, fractionation, and volume regimens with and without systemic therapy in the treatment of OPSCC are outlined for a variety of disease stages and clinical scenarios. ASCO Endorsement Panel qualifying statements and minor modifications were made to the ASTRO recommendations. The staging system that is referenced in these guidelines is the American Joint Committee on Cancer Staging Manual, 7th edition. Additional information is available at: www.asco.org/head-neck-cancer-guidelines and www.asco.org/guidelineswiki .
目的 美国放射肿瘤学会（ASTRO）制定了一项关于口咽鳞状细胞癌（OPSCC）放射治疗的循证指南，该指南被认为与美国临床肿瘤学会（ASCO）的成员有关。在应用标准的批判性评估政策和认可程序后，ASCO 选择认可 ASTRO 指南。
方法 ASTRO 指南由 ASCO 的临床专家进行临床准确性审查，由 ASCO 的方法学家进行发展严谨性审查。审查结果良好后，成立了一个 ASCO 专家小组，以审查指南内容和建议。ASCO 指南批准机构——临床实践指南委员会批准了最终认可。
结果 ASCO 专家小组确定，ASTRO 指南于 2017 年 7 月发布的建议明确、全面，并基于最相关的科学证据。ASCO 认可了 ASTRO 指南，并添加了一些限定性陈述。
推荐意见 为了在 OPSCC 的治疗中添加系统治疗以辅助放疗、在 OPSCC 的原发性手术后添加放疗并添加系统治疗、在 OPSCC 的治疗中添加诱导化疗、以及在治疗 OPSCC 时添加系统治疗的合适剂量、分割和体积方案，提出了各种疾病分期和临床情况的推荐意见。ASCO 认可小组对 ASTRO 的建议进行了限定性陈述和轻微修改。这些指南中引用的分期系统是美国癌症联合委员会的癌症分期手册，第 7 版。更多信息可在以下网址获取：www.asco.org/head-neck-cancer-guidelines 和 www.asco.org/guidelineswiki。
