| Affiliation: | 1. The University of Texas MD Anderson Cancer Center, Houston, TexasFax: (713) 563‐2331;2. Surveillance and Health Policy Research, American Cancer Society, Atlanta, Georgia;3. Otolaryngology‐Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia;4. Department of Radiation Oncology, Emory University, Atlanta, Georgia;5. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas;6. Department of Radiation Oncology, University of Wisconsin, Madison, Wisconsin;7. Hematology/Oncology Division, Vanderbilt University, Memphis, Tennessee;8. Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin;9. MedNet Solutions, Minnetonka, Minnesota;10. Otorhinolaryngology‐Head and Neck Service, University of Pennsylvania, Philadelphia, Pennsylvania;11. Department of Internal Medicine, Washington University, St. Louis, Missouri;12. Department of Internal Medicine, University of North Carolina, Chapel Hill, North Carolina;13. Department of Radiation Oncology, University of Washington, Seattle, Washington;14. Arizona Oncology Services Foundation, Phoenix, Arizona;15. Department of Medicine/Hematology‐Oncology, University of Oklahoma, Oklahoma City, Oklahoma;16. Christiana Care Health System, Wilmington, Delaware;17. Pocono Medical Center, East Stroudsburg, Pennsylvania;18. Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania |
| 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. Cancer 2012. © 2012 American Cancer Society. |
