Optimizing Radiotherapy in HPV-Associated Oropharyngeal Cancer Patients

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6 Citations (Scopus)


Concurrent chemoradiation is considered the golden standard in the treatment of locally advanced OPC. However, given the very high survival rates in favorable HPV-positive OPC and the high rates of acute and late treatment-related side effects, de-escalation strategies have to be considered. In this chapter, the potential benefit of a number of de-escalation strategies is described, including of replacement of concurrent chemotherapy by cetuximab, radiation dose de-escalation based on response to induction chemotherapy, radiotherapy alone without systemic treatment, and limiting elective nodal target volumes for radiation. In addition to de-escalation, modern radiation technologies like protons will offer increasing opportunities to decrease the dose to normal tissues in order to prevent radiation-induced toxicities. Initial analysis showed that radiation dose de-escalation based on response to induction chemotherapy in combination with intensity-modulated proton therapy (IMPT) has the highest potential to decrease acute and late toxicities.

Original languageEnglish
Title of host publicationHPV Infection in Head and Neck Cancer
EditorsWojciech Golusiński, C. René Leemans, Andreas Dietz
Number of pages11
ISBN (Electronic)978-3-319-43580-0
ISBN (Print)978-3-319-43578-7
Publication statusPublished - 2017

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