ARLINGTON, Va., April 17, 2017 -- The American Society for Radiation Oncology (ASTRO) today issued a new clinical guideline for the management of oropharyngeal cancer. The guideline, "Radiation therapy for oropharyngeal squamous cell carcinoma: An ASTRO Evidence-based Clinical Practice Guideline," is available as a free access article in Practical Radiation Oncology, ASTRO's clinical practice journal.

Drawing on data from clinical trials and other prospective studies, recommendations address the use of radiation therapy (RT), also known as radiotherapy, to treat tumors of the oropharynx in a variety of scenarios. The new clinical practice guideline covers optimal radiation dose and fractionation schedules, the integration of chemotherapy with RT and the role of induction chemotherapy.

Oropharyngeal squamous cell cancer (OPSCC) is rapidly becoming the most commonly diagnosed head and neck malignancy. The demand for radiation oncologists to treat head and neck cancer is projected to increase nearly 20 percent by 2020 over 2010 rates.1 The profile of the typical OPSCC patient has changed in the past several decades. From 1988 to 2004, the rates of human papillomavirus (HPV)-associated OPSCC rose more than 200 percent, while the rates of HPV-negative disease dropped by half.2 The estimated risk of death for HPV-positive OPSCC patients is 50 percent lower than for those with HPV-negative disease, in large part due to the more favorable biology of HPV-driven disease, but also because these patients tend to be younger and healthier when they are diagnosed.3
"Advances in treatment planning and technology, as well as a shift in the 'typical' oropharyngeal cancer patient over the past several decades, have led to a significant improvement in treatment outcomes for these patients," said David J. Sher, MD, MPH, co-chair of the task force that authored the guideline and a radiation oncologist at the University of Texas Southwestern in Dallas. "Despite these advances, however, treatment in this sensitive and complex region of the head and neck often leads to short-term, long-term and potentially lifelong side effects—which become even more salient as this patient population trends younger."

"Radiation therapy is the most commonly used curative option for the primary treatment of oropharynx tumors," said Avraham Eisbruch, MD, also co-chair of the task force and a radiation oncologist at the University of Michigan in Ann Arbor, Michigan. "We developed the current guideline to address critical topics facing radiation oncologists who treat oropharyngeal cancer, including when to use chemotherapy, as well as appropriate dose and fractionation schedules for definitive and post-surgical RT settings."

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