ACR Appropriateness Criteria® Locoregional therapy for resectable oropharyngeal squamous cell carcinomas

Expert Panel on Radiation Oncology – Head and Neck

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Background: There are no level I studies to guide treatment for resectable oropharyngeal squamous cell carcinoma (SCC). Treatment toxicities influence management recommendations. Ongoing investigations are examining deintensified treatments for human papillomavirus (HPV)-associated oropharyngeal SCC. Methods: The Appropriateness Criteria panel, using modified Delphi methodology, produced a literature summary, an assessment of treatment recommendations, and cases to illustrate their use. Results: A multidisciplinary team produces optimum results. Based on HPV status, smoking history, and staging, patients are divided into groups at low, intermediate, and high-risk of death. In the future, treatment recommendations may be influenced by HPV status, which has changed the epidemiology of oropharyngeal SCC. Conclusion: T1 to T2N0M0 resectable oropharyngeal SCC can be treated with surgery or radiation without chemotherapy. Patients with T1-2N1-2aM0 disease can receive radiation, chemoradiation, or transoral surgery with neck dissection and appropriate adjuvant therapy. Patients with T1-2N2b-3M0 disease should receive chemoradiation or transoral surgery with neck dissection and appropriate adjuvant therapy. Concurrent chemoradiation is preferred for T3 to T4 disease.

Original languageEnglish (US)
Pages (from-to)1299-1309
Number of pages11
JournalHead and Neck
Volume38
Issue number9
DOIs
StatePublished - 2016

Keywords

  • base of tongue cancer
  • human papillomavirus (HPV)
  • oropharyngeal cancer
  • tonsillar cancer
  • transoral robotic surgery (TORS)

ASJC Scopus subject areas

  • Otorhinolaryngology

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