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NCCN Flash Updates: NCCN Guidelines Updated for Head and Neck Cancers

NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), the NCCN Drugs & Biologics Compendium (NCCN Compendium®), and the NCCN Radiation Therapy Compendium™ for Head and Neck Cancers. These NCCN Guidelines® are currently available as Version 2.2023.

Link directly to the Updates section of the NCCN Guidelines: Head and Neck Cancers

ORPH-A (2 of 2)

  • Postoperative
    • RT or Concurrent Systemic Therapy/RT
      • 2nd bullet, 2nd sub-bullet, option added: De-escalation to 50 Gy may be considered in patients with p16 (HPV)-positive oropharynx cancer who have up to 4 positive lymph nodes, N1-N2 disease with ≤1 mm ENE, or cT1-T2 resected to negative or close margins (<3 mm). (category 2B)
    • Reference added: Ferris RL, Flamand Y, Weinstein GS, et al. J Clin Oncol 2022;10:138-149.

FOLL-A (1 of 2)

  • Follow-Up Recommendations
    • 2nd bullet added: AM cortisol, growth hormone (GH), free T4, prolactin, insulin-like growth factor 2 (IGF-2), luteinizing hormone (LH), follicle-stimulating hormone (FSH), serum adrenocorticotropic hormone (ACTH), and total and bioavailable testosterone levels annually to evaluate panhypopituitarism following RT to the skull base.(category 2B)
    • Reference added: VanKoevering KK, Sabetsarvestani K, Sullivan SE, et al. Pituitary dysfunction after radiation for anterior skull base malignancies: Incidence and screening. J Neurol Surg B Skull Base 2020;81:75-81. 


  • Primary Tumor (T)
    • T2 modified: Tumor ≤2 cm, with DOI >5 mm and ≤10 mm  or tumor >2 cm and ≤4 cm, with DOI* ≤10 mm 


  • The discussion section has been updated to reflect the changes in the algorithm.


For the complete updated versions of the NCCN Guidelines, NCCN Guidelines with NCCN Evidence Blocks™, the NCCN Drugs & Biologics Compendium (NCCN Compendium®), the NCCN Biomarkers Compendium®, the NCCN Chemotherapy Order Templates (NCCN Templates®), the NCCN Radiation Therapy Compendium™, and the NCCN Imaging Appropriate Use Criteria (NCCN Imaging AUC™), please visit NCCN.org.

To view the NCCN Guidelines for Patients®, please visit NCCN.org/patientguidelines.

Free NCCN Guidelines apps for iPhone, iPad, and Android devices are now available! Visit NCCN.org/apps.

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