Cancer Guidelines Database

This is a clinical practice guideline for patients with primary bone cancer. The guideline examines systemic therapy agents and radiation therapy for chordoma, chondrosarcoma, Ewing sarcoma, osteosarcoma, and giant-cell tumours of bone (GCTB). The guideline also discusses the management of relapsed disease.

This is a clinical practice guideline for patients with sarcoma or connective tissue tumours, including bone tumours. The guideline provides recommendations addressing prevention, diagnosis, staging, management, and follow-up. Diagnostic pathology, as well as treatment through chemotherapy, radiotherapy, and surgery are specifically discussed. Please note that the sub-sections within this set were published and revised at varying dates, and that the publication year referenced here refers only to the date that the guideline set was accessed online.

This is a clinical practice guideline for patients with myelodysplastic syndromes (MDS). The guideline discusses diagnostic classification, evaluation, prognostic stratification, therapeutic options, and recommended treatment approaches for MDS. There is a particular focus on supportive care, and the guideline also provides recommendations for the management of thrombocytopenia and iron overload, the treatment of related anemia, the use of low-intensity therapy (i.e. hypomethylating agents or biologic response modifiers and immunosuppressive therapy), and high-intensity therapy.

This is a clinical practice guideline for patients with multifocal recurrent or metastatic retroperitoneal sarcoma (RPS). The guideline provides recommendations on patient assessment, diagnostic processes, local and systemic treatments, as well as palliation. Specific subtypes of RPS discussed include well-differentiated/de-differentiated liposarcoma (WD/DD LPS), leiomyosarcoma (LMS), solitary fibrous tumours (SFTs), malignant peripheral nerve sheath tumours (MPNSTs), synovial sarcoma (SS), and undifferentiated pleomorphic sarcoma (UPS).

This is a clinical practice guideline for patients with AIDS-related Kaposi sarcoma. The guideline examines diagnosis, staging, treatment, and follow-up, while also providing recommendations on HIV screening and HIV therapy during cancer treatment. Antiretroviral therapy (ART), topical therapies, intralesional chemotherapy, local incisions, radiation therapy, and systemic therapy are all discussed as treatment options.

This is a clinical practice guideline for patients with primary bone cancer. The guideline examines systemic therapy agents and radiation therapy for chordoma, chondrosarcoma, Ewing sarcoma, osteosarcoma, and giant-cell tumours of bone (GCTB). The guideline also discusses the management of relapsed disease.

This is a clinical practice guideline for the management of soft tissue sarcoma (STS) in adult patients. The guideline pertains to the following five subtypes of STS: (1) STS of extremity, superficial/trunk, or head and neck, (2) retroperitoneal or intra-abdominal STS, (3) gastrointestinal stromal tumours (GISTs), (4) desmoid tumours, and (5) rhabdomyosarcoma (RMS). The guideline provides recommendations for diagnosis, staging, treatment, palliative care, and surveillance. Surgery, chemotherapy, and radiotherapy are all examined as treatment options.

This is a clinical practice guideline for adult oncology patients with neutropenia. The guideline examines the appropriate prescribing of filgrastim for these patients. Indications for which filgrastim should be used are discussed by disease site group. Disease site groups considered include breast, central nervous system, gastrointestinal, gynecologic, genitourinary, hematologic, and thoracic, amongst others.

This is a clinical practice guideline for the management of soft tissue sarcoma (STS) in adult patients. The guideline pertains to the following five subtypes of STS: (1) STS of extremity, superficial/trunk, or head and neck, (2) retroperitoneal or intra-abdominal STS, (3) gastrointestinal stromal tumours (GISTs), (4) desmoid tumours, and (5) rhabdomyosarcoma (RMS). The guideline provides recommendations for diagnosis, staging, treatment, palliative care, and surveillance. Surgery, chemotherapy, and radiotherapy are all examined as treatment options.

This is a clinical practice guideline for patients with myelodysplastic syndromes (MDS). The guideline discusses diagnostic classification, evaluation, prognostic stratification, therapeutic options, and recommended treatment approaches for MDS. There is a particular focus on supportive care, and the guideline also provides recommendations for the management of thrombocytopenia and iron overload, the treatment of related anemia, the use of low-intensity therapy (i.e. hypomethylating agents or biologic response modifiers and immunosuppressive therapy), and high-intensity therapy.

This is a clinical practice guideline for patients with primary bone cancers, including osteosarcoma, Ewing sarcoma and chondrosarcoma. The guideline examines diagnosis and treatment of these patients. Specific topics addressed include biopsy, chemotherapy, surgery, and management of lung metastases.

This is a clinical practice guideline for patients with bone cancer. The guideline focuses on chordoma, chondrosarcoma, Ewing sarcoma, osteosarcoma, and provides recommendations for treating giant cell tumour of the bone (GCTB). Workup, treatment, surveillance, and relapsed disease are discussed for each of the types of bone cancer mentioned. Staging, high-grade undifferentiated pleomorphic sarcoma of bone, and immunotherapy for bone cancer are also considered.

This is a clinical practice guideline for adult patients with soft-tissue sarcoma who are being considered for chemotherapy. The guideline provides recommendations for staging procedures and classifications, as well as treatment options based on staging results and other risk factors. Treatment options including surgery, systemic therapy, radiation therapy, and chemotherapy are discussed. Outcomes of interest include adverse events, performance status, progression-free survival, and overall survival.

This is a clinical practice guideline for patients with AIDS-related Kaposi sarcoma. The guideline examines diagnosis, staging, treatment, and follow-up, while also providing recommendations on HIV screening and HIV therapy during cancer treatment. Antiretroviral therapy (ART), topical therapies, intralesional chemotherapy, local incisions, radiation therapy, and systemic therapy are all discussed as treatment options.

This is a clinical practice guideline for patients who have received initial treatment for chordomas, who are at risk for loco-regional recurrence. The guideline provides recommendations for pre-treatment assessment, resection of recurrent or progressive disease, radiotherapy of recurrence, other local therapies, follow-up, as well as for palliative, supportive and end-of-life care. Outcomes of interest include quality of life, recurrence-free survival, and overall survival.

This is a clinical practice guideline to guide appropriate prescribing of filgrastim in adults. The guidelines looks at a variety of disease sites and is intended as a guide to facilitate a shared approach to the appropriate use of filgrastim. In order provide clarity surrounding the indications in which filgrastim should be used, the recommendations are presented by disease site.

This is a clinical practice guideline for adults (aged 18 and older) at any phase of the cancer care continuum regardless of cancer type, stage (including metastatic) or treatment plan, with some components of the guideline also applicable to the patient's family and/or caregivers. Recommendations are provided on implementation of the brief tobacco intervention using the evidence-based AAR Brief Tobacco Intervention Model which includes screening, education and assessment, treatment plan, and referral, monitoring, and follow-up. The 2015 guideline was revised in June 2016 to abbreviate the cessation intervention model to best support adoption across all CCA clinics and settings. Clinical considerations and contraindications of treatment options for cancer patients are discussed including nicotine replace therapy (NRT), bupropion, varenicline, and e-cigarettes, and the impact of tobacco use on cancer treatment is reviewed with a specific focus on erlotinib and irinotecan.

This clinical practice guideline reviews workup and treatment of bone cancer, with specific recommendations provided for chondrosarcoma, chordoma, Ewing's sarcoma family of tumors, and osteosarcoma. Surveillance and relapse is also reviewed. An overview of systemic therapy agents is provided, and principles of radiation therapy are discussed.

This is a clinical practice guideline for stem cell transplantation (SCT) in the treatment of acute lymphoblastic leukemia. The guideline establishes indications for allogeneic stem cell transplantation (allo-SCT) in the management of acute lymphoblastic leukemia (ALL) in adults. It identifies the role of reduced-intensity conditioning (RIC) regimens for SCT in the management of ALL adult patients, and the role of tyrosine-kinase inhibitors (TKIs) for patients undergoing allo-SCT for Philadelphia chromosome-positive ALL (Ph+ ALL). The guideline also discusses the role of alternative donor transplantation (haploidentical, cord blood) in the management of adult patients with ALL who lack a suitable donor. Outcomes of interest are relapse, disease-free survival, relapse-free survival, progression-free survival, and overall survival.

A clinical practice guideline for the management of adult onset sarcoma. The guideline examines the diagnosis, staging, treatment, and follow-up options for sarcoma. Imaging modalities for the purpose of diagnosis and staging are compared, while the importance of multidisciplinary care and the effects of delayed referrals to specialists are discussed. In addition, pre-operative and post-operative radiotherapy are compared, and the guideline also examines adjuvant and systemic chemotherapy, as well as surgical procedures. This guideline is wiki-based and is constantly updated as new evidence arises - this review pertains to the guideline as of April 23, 2018.

This is a clinical practice guideline for soft tissue sarcoma. The guideline examines diagnosis, treatment and follow up. Various stages are addressed, as well as a various treatment options and disease progression. Guidance is presented for specific issues (e.g., gastrointestinal stromal tumors).

This is a clinical practice guideline for adult patients with recurrent retroperitoneal sarcoma (RPS). The guideline examines pretreatment assessment, patient selection for resection of recurrence, preoperative therapy, resection, postoperative systemic therapy, and other locoregional therapies. Pretreatment assessment options discussed include imaging, pathology, patient evaluation, and review of previous treatment. Treatment for patients who are not eligible for curative resection is also addressed.

A clinical practice guideline for patients with bone metastases and spinal compression as common causes of cancer-related pain. The guideline examines radiotherapy and prophylactic steroids to reduce pain and pain flares. Outcomes of interest include improved neurological outcomes, survival, and reduced functional interference.

This is a clinical practice guideline for the follow up of malignant or aggressive musculoskeletal tumours. The guideline discusses the timing of surveillance and the type of imaging used, with a focus on FDG-PET/CT and MRI, as well as ultrasound, X-ray, and Tc-99m bone scan. Sensitivity, specificity, recurrence rate, and survival (overall and progression-free) are all considered as outcomes.

This is a clinical practice guideline for cancer patients with non-spine bone metastases. The guideline examines treatment options for these patients, which include radiotherapy, systemic therapies, and surgical stabilization, and the appropriateness of different techniques is examined for different clinical situations. Outcomes of interest include reductions in pain, and improved palliative care.

This is a clinical practice guideline for patients with soft tissue sarcoma (STS). The guideline examines the diagnosis and treatment of these patients. Diagnostic techniques discussed include local staging, distant staging, biopsy, and pathology and molecular pathology. Treatment methods discussed include surgery, radiotherapy, adjuvant chemotherapy, neoadjuvant chemotherapy, isolated limb perfusion, as well as chemotherapy and targeted agents. Therapeutic considerations for specific STS subtypes are also examined.

An international panel of radiation oncologists who specialize in sarcoma reached consensus guidelines for preoperative radiation therapy (RT) for retroperitoneal sarcoma (RPS). Many of the recommendations are based on expert opinion because of the absence of higher level evidence and thus, are best regarded as preliminary. At the time of publication, the guideline developers were awaiting data from the European Organization for Research and Treatment of Cancer (EORTC) study of pre- operative radiotherapy plus surgery versus surgery alone for patients with RPS. Further data are also anticipated pertaining to normal tissue dose constraints, particularly for bowel tolerance. Nonetheless, the guidelines can be used to establish treatment uniformity to aid future assessments of efficacy and toxicity.

This is a clinical practice guideline for adult women (18 years and older) either without breast cancer or with a recent diagnosis of breast cancer, who have a family history of breast, ovarian or a related cancer; the guideline also provides recommendations for men affected by male breast cancer. The guideline discusses oncogenetic testing aspects of breast cancer and ovarian, specifically hereditary breast cancer, the Li-Fraumeni syndrome, and the Cowden syndrome. Topics include criteria and indications for genetic testing, tests for which genes have clinical utility, and appropriate follow-up depending on results and family history.

A clinical practice guideline for patients of any age with localized Ewing's sarcoma of bone. The guideline examines surgery, radiation therapy, and combination therapy for treatment and appropriate surgical imaging. Outcomes of interest include survival and local control.

This is a clinical practice guideline for adults (aged 18 and older) at any phase of the cancer care continuum regardless of cancer type, stage (including metastatic) or treatment plan, with some components of the guideline also applicable to the patient's family and/or caregivers. The guideline provides recommendations on implementation of the brief tobacco intervention, using the evidence-based 5 A’s model (ASK, ADVISE, ASSESS, ASSIST, ARRANGE) which includes screening, education and assessment, treatment plan, and referral, monitoring, and follow-up. Clinical considerations and contraindications of treatment options for cancer patients are discussed including nicotine replace therapy (NRT), bupropion, varenicline, and e-cigarettes. The impact of tobacco use on cancer treatment is also reviewed with a specific focus on erlotinib and irinotecan.

This is a clinical practice guideline for patients with recurrent spinal metastasis resulting in metastatic epidural spinal cord compression. The guideline examines the appropriateness of various treatment options including systemic therapy, surgical intervention, radiation therapy, osteoclast inhibitors and hospice care. The appropriateness of different techniques for unique clinical situations is discussed. Outcomes of interest include neurologic status, performance status, extent of disease, spine stability and life expectancy.

This clinical practice guideline reviews workup and treatment of bone cancer, with specific recommendations provided for chondrosarcoma, chordoma, Ewing's sarcoma family of tumours, and osteosarcoma. Surveillance and relapse are also reviewed. An overview of systemic therapy agents is provided, and principles of radiation therapy are discussed.

This is a clinical practice guideline for patients of all age groups suspected of having cancers including lung and pleural, upper gastro-intestinal, lower gastrointestinal, breast, gynecological, urological, skin, head and neck, brain and central nervous system, haematological, sarcomas, and childhood cancers. Recommendations are provided on recognition and referral or investigations of cancer in primary care. Outcomes of interest include quality of life, sensitivity and specificity of diagnostic tests and signs/symptoms, positive and negative predictive values of diagnostic tests and signs/symptoms, and cost effectiveness.