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Integration of radiation therapy with systemic treatments in head and neck cancer: expert opinion and roadmap to consensus.

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Τίτλος: Integration of radiation therapy with systemic treatments in head and neck cancer: expert opinion and roadmap to consensus.
Συγγραφείς: Becherini C; Radiation Oncology, Azienda Ospedaliero - Universitaria Careggi, University of Florence, Florence, Italy., Banini M; Radiation Oncology, Azienda Ospedaliero - Universitaria Careggi, University of Florence, Florence, Italy., Blanchard P; Radiation Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France; INSERM 1018 CESP, University Paris-Saclay, Villejuif, France., Brana I; Vall d'Hebron Institute of Oncology (VHIO), Early Phase Clinical Trials Unit (UITM), Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona, Spain; Lung and Head & Neck Tumors Unit, Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona, Spain., Chua MLK; Department of Head and Neck and Thoracic Cancers, Division of Radiation Oncology, National Cancer Centre Singapore, Singapore; Oncology Academic Program, Duke-NUS Medical School, Singapore., Eriksen JG; Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark., Huang SH; Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Canada., Gregoire V; Department of Radiation Oncology, Centre Leon Berard, Lyon, France., Licitra L; Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy; Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy., Locati LD; Department of Internal Medicine and Medical Therapeutics, University of Pavia, Italy; Medical Oncology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy., Ma B; Department of Clinical Oncology, State Key Laboratory of Translational Oncology, Phase 1 Clinical Trial Centre, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region of China., Machiels JP; Department of Medical Oncology, Institut Roi Albert II, Cliniques universitaires Saint-Luc, and Institut de Recherche Clinique et Expérimentale, Université catholique de Louvain (UCLouvain), Brussels, Belgium., Saintigny P; Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, CRCL, Lyon, France; Department of Medical Oncology, Centre Léon Bérard, Lyon, France; CASTING - Cancer Dynamics, Adaptation and Modeling, INRIA, INSERM, Ecole Normale Supérieure de Lyon, Centre Léon Bérard, CNRS and University Claude Bernard Lyon 1, Lyon, France., Tinhofer I; Department of Radiooncology and Radiotherapy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany., Livi L; Radiation Oncology, Azienda Ospedaliero - Universitaria Careggi, University of Florence, Florence, Italy., Bossi P; Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy., Harrington KJ; The Institute of Cancer Research/Royal Marsden Hospital, London, UK., Bonomo P; Radiation Oncology, Azienda Ospedaliero - Universitaria Careggi, University of Florence, Florence, Italy. Electronic address: bonomop@aou-careggi.toscana.it.
Πηγή: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2026 Oct; Vol. 223, pp. 111711. Date of Electronic Publication: 2026 Jul 28.
Τύπος έκδοσης: Journal Article
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Elsevier Scientific Publishers Country of Publication: Ireland NLM ID: 8407192 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-0887 (Electronic) Linking ISSN: 01678140 NLM ISO Abbreviation: Radiother Oncol Subsets: MEDLINE
Imprint Name(s): Publication: Limerick : Elsevier Scientific Publishers
Original Publication: Amsterdam : Elsevier Science Publishers, c1983-
Ιατρικοί όροι (MeSH): Head and Neck Neoplasms*/therapy , Head and Neck Neoplasms*/pathology , Squamous Cell Carcinoma of Head and Neck*/pathology , Squamous Cell Carcinoma of Head and Neck*/therapy , Consensus Statements as Topic*, Humans ; Combined Modality Therapy ; Consensus
Περίληψη: Background: Integration of radiation therapy (RT) with systemic treatments in head and neck cancers has transformed therapeutic paradigms, yet optimal combinations remain undefined. This study aimed to identify priority areas of unmet need in combining RT with systemic treatment in both squamous cell carcinoma of the head and neck (SCCHN) and nasopharyngeal cancer (NPC).
Methods: A multidisciplinary panel of international experts in radiation, clinical, and medical oncology convened to identify priority areas of unmet need. Four clinical scenarios were evaluated: locally-advanced (LA) SCCHN; recurrent/metastatic (R/M) SCCHN; LA NPC; and R/M NPC. Experts ranked a predefined shortlist of topics using weighted Borda count methodology and proposed ideal clinical trial designs to address the identified unmet needs.
Results: Fifteen expert responses identified eight priority topics across the four scenarios. In locally-advanced SCCHN, top priorities included risk-adapted prognostic evaluation at diagnosis and personalized chemoradiation following peri-operative immunotherapy. For R/M SCCHN, experts highlighted the role of locoregional radiation in de-novo metastatic disease on first-line therapy and treatment sequencing in oligometastatic programmed death ligand-1 (PD-L1) combined positive score (CPS)-positive disease as the key need. In LA NPC, the leading topics were patient selection for intensification strategies and for de-escalation after induction chemo-immunotherapy. In R/M NPC, experts prioritized sequencing locoregional RT and metastasis-directed therapy in patients with de-novo oligometastatic disease who are benefiting from first-line treament.
Conclusions: This study defines critical knowledge gaps in integrating RT with systemic treatments in head and neck cancer, and provides a roadmap for future international consensus development and clinical research to advance personalized treatment strategies.
(Copyright © 2026 Elsevier B.V. All rights reserved.)
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Contributed Indexing: Keywords: Chemotherapy; Consensus; Head and neck cancer; Immunotherapy; Radiation therapy
Entry Date(s): Date Created: 20260728 Date Completed: 20260924 Latest Revision: 20260928
Update Code: 20260929
DOI: 10.1016/j.radonc.2026.111711
PMID: 42520977
Βάση Δεδομένων: MEDLINE
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  Data: Integration of radiation therapy with systemic treatments in head and neck cancer: expert opinion and roadmap to consensus.
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  Data: <searchLink fieldCode="AU" term="%22Becherini+C%22">Becherini C</searchLink>; Radiation Oncology, Azienda Ospedaliero - Universitaria Careggi, University of Florence, Florence, Italy.<br /><searchLink fieldCode="AU" term="%22Banini+M%22">Banini M</searchLink>; Radiation Oncology, Azienda Ospedaliero - Universitaria Careggi, University of Florence, Florence, Italy.<br /><searchLink fieldCode="AU" term="%22Blanchard+P%22">Blanchard P</searchLink>; Radiation Oncology Department, Gustave Roussy Cancer Campus, Villejuif, France; INSERM 1018 CESP, University Paris-Saclay, Villejuif, France.<br /><searchLink fieldCode="AU" term="%22Brana+I%22">Brana I</searchLink>; Vall d'Hebron Institute of Oncology (VHIO), Early Phase Clinical Trials Unit (UITM), Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona, Spain; Lung and Head & Neck Tumors Unit, Department of Medical Oncology, Vall d'Hebron University Hospital, Barcelona, Spain.<br /><searchLink fieldCode="AU" term="%22Chua+MLK%22">Chua MLK</searchLink>; Department of Head and Neck and Thoracic Cancers, Division of Radiation Oncology, National Cancer Centre Singapore, Singapore; Oncology Academic Program, Duke-NUS Medical School, Singapore.<br /><searchLink fieldCode="AU" term="%22Eriksen+JG%22">Eriksen JG</searchLink>; Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark.<br /><searchLink fieldCode="AU" term="%22Huang+SH%22">Huang SH</searchLink>; Department of Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Canada.<br /><searchLink fieldCode="AU" term="%22Gregoire+V%22">Gregoire V</searchLink>; Department of Radiation Oncology, Centre Leon Berard, Lyon, France.<br /><searchLink fieldCode="AU" term="%22Licitra+L%22">Licitra L</searchLink>; Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy; Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy.<br /><searchLink fieldCode="AU" term="%22Locati+LD%22">Locati LD</searchLink>; Department of Internal Medicine and Medical Therapeutics, University of Pavia, Italy; Medical Oncology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy.<br /><searchLink fieldCode="AU" term="%22Ma+B%22">Ma B</searchLink>; Department of Clinical Oncology, State Key Laboratory of Translational Oncology, Phase 1 Clinical Trial Centre, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region of China.<br /><searchLink fieldCode="AU" term="%22Machiels+JP%22">Machiels JP</searchLink>; Department of Medical Oncology, Institut Roi Albert II, Cliniques universitaires Saint-Luc, and Institut de Recherche Clinique et Expérimentale, Université catholique de Louvain (UCLouvain), Brussels, Belgium.<br /><searchLink fieldCode="AU" term="%22Saintigny+P%22">Saintigny P</searchLink>; Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, CRCL, Lyon, France; Department of Medical Oncology, Centre Léon Bérard, Lyon, France; CASTING - Cancer Dynamics, Adaptation and Modeling, INRIA, INSERM, Ecole Normale Supérieure de Lyon, Centre Léon Bérard, CNRS and University Claude Bernard Lyon 1, Lyon, France.<br /><searchLink fieldCode="AU" term="%22Tinhofer+I%22">Tinhofer I</searchLink>; Department of Radiooncology and Radiotherapy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.<br /><searchLink fieldCode="AU" term="%22Livi+L%22">Livi L</searchLink>; Radiation Oncology, Azienda Ospedaliero - Universitaria Careggi, University of Florence, Florence, Italy.<br /><searchLink fieldCode="AU" term="%22Bossi+P%22">Bossi P</searchLink>; Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy.<br /><searchLink fieldCode="AU" term="%22Harrington+KJ%22">Harrington KJ</searchLink>; The Institute of Cancer Research/Royal Marsden Hospital, London, UK.<br /><searchLink fieldCode="AU" term="%22Bonomo+P%22">Bonomo P</searchLink>; Radiation Oncology, Azienda Ospedaliero - Universitaria Careggi, University of Florence, Florence, Italy. Electronic address: bonomop@aou-careggi.toscana.it.
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  Data: Background: Integration of radiation therapy (RT) with systemic treatments in head and neck cancers has transformed therapeutic paradigms, yet optimal combinations remain undefined. This study aimed to identify priority areas of unmet need in combining RT with systemic treatment in both squamous cell carcinoma of the head and neck (SCCHN) and nasopharyngeal cancer (NPC).<br />Methods: A multidisciplinary panel of international experts in radiation, clinical, and medical oncology convened to identify priority areas of unmet need. Four clinical scenarios were evaluated: locally-advanced (LA) SCCHN; recurrent/metastatic (R/M) SCCHN; LA NPC; and R/M NPC. Experts ranked a predefined shortlist of topics using weighted Borda count methodology and proposed ideal clinical trial designs to address the identified unmet needs.<br />Results: Fifteen expert responses identified eight priority topics across the four scenarios. In locally-advanced SCCHN, top priorities included risk-adapted prognostic evaluation at diagnosis and personalized chemoradiation following peri-operative immunotherapy. For R/M SCCHN, experts highlighted the role of locoregional radiation in de-novo metastatic disease on first-line therapy and treatment sequencing in oligometastatic programmed death ligand-1 (PD-L1) combined positive score (CPS)-positive disease as the key need. In LA NPC, the leading topics were patient selection for intensification strategies and for de-escalation after induction chemo-immunotherapy. In R/M NPC, experts prioritized sequencing locoregional RT and metastasis-directed therapy in patients with de-novo oligometastatic disease who are benefiting from first-line treament.<br />Conclusions: This study defines critical knowledge gaps in integrating RT with systemic treatments in head and neck cancer, and provides a roadmap for future international consensus development and clinical research to advance personalized treatment strategies.<br /> (Copyright © 2026 Elsevier B.V. All rights reserved.)
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  Data: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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