Reevaluation of postoperative radiation dose in the management of human papillomavirus–positive oropharyngeal cancer

  title={Reevaluation of postoperative radiation dose in the management of human papillomavirus–positive oropharyngeal cancer},
  author={Re-I Chin and Christopher Spencer and Todd A. DeWees and Michael Y Hwang and Pranav V. Patel and Parul Sinha and Hiram A. Gay and Bruce H. Haughey and Brian Nussenbaum and Douglas R. Adkins and James S. Lewis and Wade L. Thorstad},
  journal={Head \& Neck},
The purpose of this study was to compare outcomes of patients with p16‐positive oropharyngeal squamous cell carcinoma (SCC) treated with postoperative intensity‐modulated radiotherapy (IMRT) before and after an institutional dose reduction policy effective on February 2009. 

Multi‐institutional analysis of outcomes following transoral surgery for HPV‐positive oropharyngeal squamous cell carcinoma in elderly patients

The incidence of human papillomavirus (HPV)‐related oropharyngeal squamous cell carcinoma (OPSCC) is rising, even in elderly patients. The outcomes of transoral surgery (TOS) in this population are

Surgical Margin Determination in the Era of HPV‐Positive Oropharyngeal Cancer

Establishing a standard regarding close margins in HPV-mediated oropharyngeal carcinoma (OPSCC) may allow for the optimization of outcomes and help define best practices.

Postoperative radiotherapy dose requirement in standard combined‐modality practice for head and neck squamous cell carcinoma: Analysis of salient surgical and radiotherapy parameters in 2 cohorts

This study compared 2 sequential cohorts to identify the postoperative radiotherapy (PORT) dose requirement for head and neck squamous cell carcinoma (HNSCC).

Long‐term analysis of transorally resected p16 + Oropharynx cancer: Outcomes and prognostic factors

An updated analysis of a p16‐positive, oropharyngeal carcinoma cohort treated primarily with transoral laser microsurgery (TLM) with extended follow-up is presented to address long‐term outcomes of primary transoral surgery for this unique disease.

Pretreatment metabolic tumor volume as a prognostic factor in HPV‐associated oropharyngeal cancer in the context of AJCC 8th edition staging

This study evaluates the prognostic significance of 18F‐fluorodeoxyglucose‐positron emission tomography ([F‐18]FDG‐PET)‐derived metabolic tumor volume (MTV) in human papillomavirus (HPV)‐associated

De-intensification of adjuvant therapy in human papillomavirus-associated oropharyngeal cancer

There is significant interest in adjuvant treatment de-intensification of HPV-OPC patients in order to reduce treatment-related toxicity while maintaining excellent clinical outcomes.

Head and Neck Cancers

This chapter discusses the general management of patients with head and neck cancers, with special focus on principles that guide radiotherapy management. Several key components of trimodality care

The Efficacy of Low Postoperative Radiation Dose in Patients with Advanced Hypopharyngeal Cancer without High-Risk Factors

This study suggests that treating no high-risk factors for locally advanced HPSCC with a dose of 50 Gy to the whole operative bed and elective lymph node levels cannot compromise disease control and survival.

Treatment de‐escalation for HPV+ oropharyngeal cancer: A systematic review and meta‐analysis

In patients with HPV+ OPC, de‐escalation treatments should not be widely and agnostically adopted in clinical practice, as therein lies a concrete risk of offering a sub‐optimal treatment to patients.



Extracapsular spread and adjuvant therapy in human papillomavirus‐related, p16‐positive oropharyngeal carcinoma

The role of ECS as a prognosticator and adjuvant therapy determinant in surgically resected, human papillomavirus‐related oropharyngeal squamous cell carcinoma (OPSCC) has never been determined.

Nodal status is not a prognostic factor in patients with HPV‐positive oral/oropharyngeal tumors

The primary aim is to compare the prognostic parameters in patients with HPV‐positive and HPV‐negative tumors and the patterns of treatment failure between these groups.

Extracapsular spread in head and neck carcinoma: Impact of site and human papillomavirus status

The prognostic value of ECS in cervical lymph node metastases from head and neck squamous cell carcinoma was evaluated for patients with oropharyngeal SCC (OPC; with known p16/human papillomavirus [HPV] status) and for Patients with SCC of the oral cavity (OCC).

Eliminating radiotherapy to the contralateral retropharyngeal and high level II lymph nodes in head and neck squamous cell carcinoma is safe and improves quality of life

Patients who received treatment for HNSCC using intensity‐modulated radiation therapy (IMRT) that eliminated the treatment of contralateral retropharyngeal lymph nodes (RPLNs) in the clinically uninvolved neck are reported on.

Human papillomavirus and survival of patients with oropharyngeal cancer.

Tumor HPV status is a strong and independent prognostic factor for survival among patients with oropharyngeal cancer and the risk of death significantly increased with each additional pack-year of tobacco smoking.

Margin mapping in transoral surgery for head and neck cancer

To evaluate the results of patients treated by transoral laser microsurgery and margin mapping with attention to deep margin dimensions in the lateral pharyngeal wall, transoral lasers are used in conjunction with margin mapping for the first time.

Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck.

Among high-risk patients with resected head and neck cancer, concurrent postoperative chemotherapy and radiotherapy significantly improve the rates of local and regional control and disease-free survival, however, the combined treatment is associated with a substantial increase in adverse effects.

Evaluation of the dose for postoperative radiation therapy of head and neck cancer: first report of a prospective randomized trial.

Transoral laser microsurgery as primary treatment for advanced‐stage oropharyngeal cancer: A united states multicenter study

The aim of this study was to evaluate outcomes of a minimally invasive approach, using transoral laser microsurgery (TLM) as the primary treatment for advanced oropharyngeal carcinoma.