The literature was searched using MEDLINE (OVID: 1966 through September 2004), EMBASE (OVID:1980 through September 2004), the Cochrane Library (OVID: Issue 2, 2004), the Physician Data Query database, the Canadian Medical Association Infobase, and the National Guideline Clearinghouse. In addition, the proceedings of the meetings of the American Society of Clinical Oncology (1997-2004), the American Society for Therapeutic Radiology and Oncology (1992-2003), the European Society of Therapeutic Radiology and Oncology (2000, 2002), and the European Society for Medical Oncology (1998, 2000, 2002) were searched for relevant abstracts. Article bibliographies and personal files were also searched to September 2004 for evidence relevant to this practice guideline report.
The literature search of the electronic databases combined disease specific terms (head and neck neoplasms/ or carcinoma, squamous cell/ or head and neck cancer.mp.) with treatment specific terms in the postoperative setting (drug therapy/ or chemotherapy/ or radiochemotherapy.mp. or chemoradiotherapy.mp.) and search specific terms for the following study designs: practice guidelines, systematic reviews, meta-analyses, randomized controlled trials, and clinical trials.
Inclusion Criteria
Articles were selected for inclusion in the systematic review of the evidence if they were published reports or published abstracts of randomized controlled trials that:
- Included patients with newly diagnosed locally advanced squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx
- Compared any combination of postoperative concurrent chemoradiotherapy versus the identical postoperative radiotherapy regimen alone
- Reported results for the outcomes of interest: locoregional control, distant metastases, progression-free survival, disease-free survival, overall survival, adverse events, and aspects related to quality of life
Practice guidelines, meta-analyses, or systematic reviews explicitly based on randomized trials related to the guideline question were also eligible for inclusion in the systematic review of the evidence.
Exclusion Criteria
Articles were excluded from the systematic review of the evidence if they were any of the following:
- Papers published in a language other than English.