A systematic review of international/national guidelines for the management of nasopharyngeal carcinoma: Convergence and divergence of recommendations
Year: 2026
Type: review
Study design: Systematic Review
Abstract: Increasing numbers of clinical practice guidelines have been published by international/national groups for nasopharyngeal carcinoma (NPC), providing valuable references for clinicians in making evidence-based decisions on treatment. However, there are substantial discrepancies in various recommendations, leading to uncertainties in choosing the optimal strategies. The authors systematically searched databases and organizational websites for NPC guidelines published between January 2000 and November 2025. All identified guidelines underwent quality appraisal; in total, 26 clinical practice guidelines rated recommended for use were included. The recommendations covering all management aspects (diagnosis, staging, radiotherapy, systemic therapy, follow-up surveillance, biomarkers, and salvage of recurrent/metastatic diseases) were summarized and comparatively analyzed for consistency and disparities. Strong consensus exists for diagnostic workup, staging systems, and induction chemotherapy plus concurrent chemoradiotherapy for advanced disease, whereas marked disparities exist on radiotherapy details, particularly target volume delineation, elective coverage extent, and dose specifications. Although systemic therapy strategies for different stage groups were mostly consistent, substantial disparities exist in alternative options and treatment details. This first comprehensive systematic synthesis of international NPC guidelines provides a practical reference for clinicians to understand all recommendations and select optimal options based on local resources and expertise while identifying current controversies that demand future research for further standardization and harmonization.
Source: Cancer
DOI: 10.1002/cncr.70604
Institutions: Fujian Medical University, Union Hospital, University of Hong Kong, University of Indonesia, Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo, University of Hong Kong - Shenzhen Hospital, Fujian Provincial Cancer Hospital, Universidad de Oviedo, Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias, Institute of Oncology Ljubljana, Queen Elizabeth Hospital, Jena University Hospital, Sri Shankara Cancer Hospital and Research Center, Austin Hospital, Austin Health, Universitair Ziekenhuis Leuven, KU Leuven, Emory University, Winship Cancer Institute, Universidad de Deusto, Donostiako Unibertsitate Ospitalea
Language: English
Topic: Head and Neck Cancer Studies
Subfield: Otorhinolaryngology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G3427901029, G5114425407
OpenAlex ID: W7212306205