TY - JOUR
T1 - ACR Appropriateness Criteria® Locoregional therapy for resectable oropharyngeal squamous cell carcinomas
AU - Expert Panel on Radiation Oncology – Head and Neck
AU - Beitler, Jonathan J.
AU - Quon, Harry
AU - Jones, Christopher U.
AU - Salama, Joseph K.
AU - Busse, Paul M.
AU - Cooper, Jay S.
AU - Koyfman, Shlomo A.
AU - Ridge, John A.
AU - Saba, Nabil F.
AU - Siddiqui, Farzan
AU - Smith, Richard V.
AU - Worden, Francis
AU - Yao, Min
AU - Yom, Sue S.
N1 - Publisher Copyright:
© 2016 Wiley Periodicals, Inc.
PY - 2016/9
Y1 - 2016/9
N2 - 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.
AB - 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.
KW - base of tongue cancer
KW - human papillomavirus (HPV)
KW - oropharyngeal cancer
KW - tonsillar cancer
KW - transoral robotic surgery (TORS)
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U2 - 10.1002/hed.24447
DO - 10.1002/hed.24447
M3 - Article
C2 - 27330003
AN - SCOPUS:84987808218
SN - 0148-6403
VL - 38
SP - 1299
EP - 1309
JO - Head and Neck Surgery
JF - Head and Neck Surgery
IS - 9
ER -