Latin American Consensus on the Treatment of Head and Neck Cancer.

Head and neck squamous cell carcinoma (HNSCC) is well known as a serious health problem worldwide, especially in low-income countries or those with limited resources, such as most countries in Latin America. International guidelines cannot always be applied to a population from a large region with specific conditions. This study established a Latin American guideline for care of patients with head and neck cancer and presented evidence of HNSCC management considering availability and oncologic benefit. A panel composed of 41 head and neck cancer experts systematically worked according to a modified Delphi process on (1) document compilation of evidence-based answers to different questions contextualized by resource availability and oncologic benefit regarding Latin America (region of limited resources and/or without access to all necessary health care system infrastructure), (2) revision of the answers and the classification of levels of evidence and degrees of recommendations of all recommendations, (3) validation of the consensus through two rounds of online surveys, and (4) manuscript composition. The consensus consists of 12 sections: Head and neck cancer staging, Histopathologic evaluation of head and neck cancer, Head and neck surgery-oral cavity, Clinical oncology-oral cavity, Head and neck surgery-oropharynx, Clinical oncology-oropharynx, Head and neck surgery-larynx, Head and neck surgery-larynx/hypopharynx, Clinical oncology-larynx/hypopharynx, Clinical oncology-recurrent and metastatic head and neck cancer, Head and neck surgery-reconstruction and rehabilitation, and Radiation therapy. The present consensus established 48 recommendations on HNSCC patient care considering the availability of resources and focusing on oncologic benefit. These recommendations could also be used to formulate strategies in other regions like Latin America countries.

Tradução para a língua portuguesa do M.D. Anderson Symptom Inventory - head and neck module (MDASI-H&N) / Translation of the M.D. Anderson Symptom Inventory - head and neck module (MDASI-H&N) to Brazilian Portuguese

Introdução: Pacientes com câncer de cabeça e pescoço (CCP) apresentam diversos sintomas durante o curso de sua doença, sejam decorrentes do câncer ou do tratamento. Entretanto, esses sintomas são raramente avaliados de forma rotineira, resultando em identificação tardia, piora da qualidade da vida, com impacto significativo na capacidade funcional dos pacientes e nos custos da assistência. Há diversos instrumentos genéricos disponíveis para avaliar múltiplos sintomas em pacientes com câncer e, ao menos, dois específicos para pacientes com CCP (o Head and Neck Distress Scale [HNDS] e o M. D. Anderson Symptom Inventory - Head&Neck [MDASI-H&N]). Infelizmente, nenhum desses instrumentos foi traduzido ou validado para o português do Brasil. Objetivo: Apresentar a tradução da versão brasileira do MDASI-H&N, uma ferramenta simples, de auto-relato, validada na língua inglesa, específica para avaliar a presença e intensidade de múltiplos sintomas em pacientes com CCP e o impacto desses sintomas na vida diária. Métodos: Foi realizada tradução e retrotradução do MDASI-H&N, considerando os padrões internacionalmente recomendados, sendo as versões finais comparadas e avaliadas por comitê de pesquisadores brasileiros e do hospital M. D. Anderson Cancer Center. Resultados: O instrumento traduzido é apresentado nessa publicação e, atualmente, passa por processo de validação clínica no Brasil. Conclusão: Por ser um instrumento padronizado internacionalmente e racionalmente estabelecido, recomenda-se que, após sua validação em português, o MDASI-H&N seja adotado como a ferramenta padrão-ouro para avaliação sintomática de pacientes de cabeça e pescoço em protocolos clínicos conduzidos no Brasil e na prática clínica diária.

Introduction: Head and neck cancer (HNC) patients present multiple symptoms during the course of their disease, either as a result of cancer itself or its treatment. Nonetheless, these symptoms are rarely systematically assessed, leading to delays in their identification, quality of life deterioration, thus resulting in significant impact on patient functional capacity and costs of health care. Generic instruments for symptom evaluation in cancer patients are available, and two have been specifically designed for HNC (the Head and Neck Distress Scale [HNDS] and the M. D. Anderson Symptom Inventory - Head&Neck [MDASI-H&N]). Unfortunately, none of these tools have been translated to or validated in Brazilian Portuguese. Objective: To describe the Brazilian Portuguese version of the MDASI-H&N, a simple, self-reporting tool, which was originally developed and validated in English. It was specifically designed to assess the occurrence and severity of multiple symptoms, the overall symptom burden, and the interference of these symptoms with daily life. Methods: Translation and back-translation of the MDASI-H&N to Brazilian Portuguese were performed. The final versions were compared and contrasted by a committee composed of investigators from Brazil and from M. D. Anderson Cancer Center. Results: The translated instrument is presented herein. It is currently undergoing clinical validation in Brazil. Conclusion: Since the MDASI-H&N is an internationally standardized and rationally designed instrument, we strongly recommend that, after the clinical validation in Portuguese, this tool be adopted as the gold-standard instrument for symptom evaluation in HNC patients participating in clinical studies in Brazil, as well as in routine clinical practice.