New recommendations for radiation therapy in HPV-associated oropharyngeal cancer

Dana-Farber Cancer InstituteJun 18 2024

Study title: Radiation Therapy for HPV-Positive Oropharyngeal Squamous Cell Carcinoma: An ASTRO Clinical Practice Guideline

Publication: Practical Radiation Oncology

Dana-Farber Cancer Institute author: Danielle Margalit, MD, MPH

Summary: A multi-disciplinary task force convened by the American Society for Radiation Oncology has issued new guidelines for radiation therapy for HPV-associated oropharyngeal squamous cell carcinoma (OPSCC). The expert task force recommends optimal dosing regimens for radiation therapy when used alone or after surgery, incorporating the latest data on minimizing doses to areas that may affect patient quality of life such as swallowing. Concurrent cisplatin chemotherapy is recommended for more advanced tumors or multiple lymph nodes.

For patients ineligible for cisplatin, a shared decision-making approach is emphasized and concurrent cetuximab, carboplatin/5-fluorouracil, or taxane-based systemic therapy are conditionally recommended. Recommendations are also given for post-treatment assessment of response to therapy.

The guideline additionally includes recommendations for postoperative settings.

Significance: New recommendations on the optimal use of radiation therapy for HPV-associated OPSCC are based on evidence from multiple clinical trials and aim to maintain good outcomes and reduce acute and late effects.

Funding: American Society for Radiation Oncology