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Eur Arch Otorhinolaryngol. 2016 Oct;273(10):2877-94. doi: 10.1007/s00405-015-3771-x. Epub 2015 Oct 13.

Management of locally advanced HPV-related oropharyngeal squamous cell carcinoma: where are we?

Author information

1
Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA.
2
Departments of Radiation Oncology, Otolaryngology and Medical Oncology, Emory University School of Medicine, Atlanta, GA, USA.
3
Division of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
4
Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, MI, USA.
5
Department of Hematology and Medical Oncology, The Winship Cancer Institute of Emory University, Atlanta, GA, USA.
6
Department of Head and Neck Surgery and Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
7
Department of Radiation Oncology, The Prince of Wales Cancer Centre, Sydney, NSW, Australia.
8
Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia.
9
Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.
10
Instituto Universitario de Oncología del Principado de Asturias, Universidad de Oviedo, Oviedo, Spain.
11
Department of Radiation Oncology, University of Florida, Gainesville, FL, USA.
12
Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
13
Division of Oncology, Department of Medicine, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.
14
Department of Head and Neck Surgery, Greek Anticancer Institute, Saint Savvas Hospital, Athens, Greece.
15
University of Udine School of Medicine, Udine, Italy.
16
Coordinator of the International Head and Neck Scientific Group, Padua, Italy. a.ferlito@uniud.it.

Abstract

HPV-related (HPV+) oropharyngeal cancer (OPC) has a better prognosis compared to HPV unrelated (HPV-) OPC. This review summarizes and discusses several of the controversies regarding the management of HPV+ OPC, including the mechanism of its treatment sensitivity, modern surgical techniques, chemotherapy regimens, and treatment de-intensification protocols. We also discuss and reconsider potential adverse prognostic factors such as tumor EGFR expression, tumor hypoxia, and patient smoking history, as well as the significance of retropharyngeal adenopathy. Finally, we discuss elective nodal treatment of uninvolved lymph node stations. While this review does not exhaust all controversies related to the management of HPV+ OPC, it aims to highlight some of the most clinically relevant ones.

KEYWORDS:

Cetuximab; EGFR; HPV; Hypoxia; Oropharyngeal carcinoma; Radiosensitivity; TORS; Treatment de-intensification; p16

PMID:
26463714
DOI:
10.1007/s00405-015-3771-x
[Indexed for MEDLINE]

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