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Comparative Effectiveness and Safety of Radiotherapy Treatments for Head and Neck Cancer

• CME Information
• Faculty Biographies & Disclosures
• References
• Course Presentations
• CME Posttest

CME Information

Course Overview Educational Objectives Target Audience Method of Participation

Accreditation Statement Term of Approval Peer Review Program Director

Disclaimer Disclosure Acknowledgement of Support

Course Overview

Treatment for head and neck cancer often involves one of the following types of external-beam radiation: two-dimensional radiation therapy (2DRT), three-dimensional conformal radiation therapy (3DCRT), intensity modulated radiation therapy, or proton beam therapy. In recent years, the techniques for external-beam radiation therapy have evolved with the intended purpose of delivering more radiation to the tumor while sparing normal tissues and adjacent vulnerable organs. Throughout the United States, there has been widespread adoption of IMRT to treat head and neck cancer, yet few prospective, randomized studies have directly compared the clinical effectiveness of IMRT with that of either 3DCRT or 2DRT. Proton beam therapy is less commonly used. This CME activity will provide an overview of the comparative effectiveness and safety of external-beam radiation modalities used to treat head and neck cancers.

This CME activity was developed from Samson DJ, Ratko TA, Rothenberg BM, Brown HM, Bonnell CJ,Ziegler KM, Aronson N. Comparative Effectiveness and Safety of Radiotherapy Treatments for Head and Neck Cancer. Comparative Effectiveness Review No. 20. (Prepared by Blue Cross and Blue Shield Association Technology Evaluation Center Evidence-based Practice Center under Contract No. 290-02-0026.) Rockville, MD: Agency for Healthcare Research and Quality. May 2010. Available at: www.effectivehealthcare.ahrq.gov/reports/final.cfm.

Educational Objectives

At the conclusion of this activity, the participant should be able to:

• Differentiate the theoretical benefits and harms of IMRT when compared with 3DCRT and 2DRT.
• Describe the comparative effectiveness of IMRT, 3DCRT, and 2DRT with regard to adverse events and quality of life for patients with head and neck cancer and identify gaps in the current evidence base.

Target Audience

This CME activity is designed to meet the educational needs of primary care and internal medicine physicians, as well as health care professionals who treat patients with radiotherapy for head and neck cancer.

Method of Participation

This activity is in PowerPoint file format and is accompanied by talking points and references linked to PubMed abstracts.

To receive a maximum of 1.0 AMA PRA Category 1 Credit(s)™ you should:

• View the presentations in this enduring material.
• Complete the posttest (you must answer 8 out of 10 questions correctly).
• Complete and submit the CME registration and evaluation forms.

The estimated time to complete this activity, including review of the materials, is 1.0 hour(s).

Hardware/software requirements: Activities should be run with recent versions of common browsers, including Internet Explorer, Firefox, and Google Chrome.

If you have questions about the participation process, please e-mail the Office of Continuing Medical Education, cme@bcm.edu or phone 713.798.8237.

Accreditation/Credit Designation

Baylor College of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Baylor College of Medicine designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.    

Term of Approval

November 2010 through November 2013. Original release date: November 2010

Peer Review

In October 2010, this continuing medical education activity was reviewed by Andy Trotti, M.D., a professor in the Radiation Oncology Department at the H. Lee Moffitt Cancer Center in Tampla, Florida.

Disclosures: research support – EUSA Pharma; speakers bureau membership – National Comprehensive Cancer Network; advisory committee membership – GlaxoSmithKline; honorarium recipient – Johns Hopkins University; consultancy – National Cancer Institute.

Program Director

Anuja Jhingran, M.D.
Professor
Department of Radiation Oncology
The University of Texas M. D. Anderson Cancer Center
Houston, Texas

Disclosure: nothing to disclose.

Disclaimer

This CME activity is designed for use by healthcare professionals for educational purposes only. Information and opinion offered by the contributors represent their viewpoints. Conclusions drawn by the participant should be derived from careful consideration of all available scientific information. Prescription information and use of medical devices should be undertaken only after confirmation of information by consulting the FDA-approved uses and information.

Baylor College of Medicine makes every effort to have accurate information presented, no warranty, expressed or implied, is offered. The participant should use his/her clinical judgment, knowledge, experience, and diagnostic decision-making before applying any information, whether provided here or by others, for any professional use.

Links are provided to other Internet sites solely for the convenience of users. Once you link to another site, you are subject to the site's terms and conditions of use including copyright and licensing restrictions.

Disclosure

The Office of Continuing Medical Education (OCME) makes every effort to develop CME activities that are scientifically based, accurate, current, and objectively presented. In accordance with the Accreditation Council for Continuing Medical Education Standards for Commercial Support ^SM, Baylor College of Medicine (BCM) has implemented a mechanism requiring everyone in a position to control the content of an educational activity (e.g., directors, planning committee members, contributors, peer reviewers) to disclose any relevant financial relationships with commercial interests (drug/device companies) and manage/resolve any conflicts of interest prior to the activity. Individuals must disclose to participants the existence or non-existence of financial relationships: l) at the time of the activity or within 12 months prior; and 2) of their spouses/partners.

Baylor College of Medicine does not view the existence of interests or relationships with commercial entities as implying bias or decreasing the value of a presentation. It is up to the participants to determine whether the interests or relationships influence the presenter with regard to exposition or conclusions.

If at any time during this activity you feel that there has been commercial or promotional bias, please inform us by using the commercial bias comments box in the evaluation form. Please answer the questions about balance in the CME activity evaluation candidly.

The following individual(s) has/have reported financial or other relationship(s) with commercial entities whose products/services may relate to the educational content of this activity:

David J. Samson, Contributor: advisory committee membership – Evidence Development and Coverage Advisory Committee, Radiation Therapy for Localized Prostate Cancer.

Adam S. Garden, M.D., Contributor: board membership – LORHAN Advisory Board.

Andy Trotti, M.D., Peer Reviewer: research support – EUSA Pharma; speakers bureau membership – National Comprehensive Cancer Network; advisory committee membership – GlaxoSmithKline; honorarium recipient – Johns Hopkins University; consultancy – National Cancer Institute.

The following individual(s) has/have reported no financial or other relationships with commercial entities whose products/services may relate to the educational content of this activity:

Anuja Jhingran, M.D., Activity Director: nothing to disclose.

Some drugs/devices identified during this activity may have United States Food and Drug Administration (FDA) clearance for specific purposes only or for use in restricted research settings. The FDA has stated that it is the responsibility of the individual physician to determine the FDA status of each drug or device that he/she wishes to use in clinical practice and to use the products in compliance with the applicable law.

Baylor College of Medicine requires that all contributors disclose an unlabeled use or investigational use (not yet approved for any purpose) of pharmaceutical and medical device products, and provide adequate scientific and clinical justification for such use. Physicians are urged to fully review all the available data on products or procedures before using them to treat patients.

Acknowledgement of Support

This CME activity is supported by a contract, HHSA290200810015C, from the Agency for Healthcare Research and Quality.

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