Oropharyngeal cancer
ICD-10 C10 · ICD-11 2B6A

Treatment of Locally Advanced Oropharyngeal Cancer (Tongue Base, Soft Palate, or Tonsils) in the Context of HPV/p16 Status

This protocol covers oropharyngeal cancers originating in the back of the tongue, soft palate, or tonsils that have grown into nearby tissues and/or spread to nearby lymph nodes in the neck, where HPV/p16 status determines the applicable staging framework.

Clinical Scenario

These are larger cancers in the back of the tongue, soft palate, and tonsils that have grown into nearby tissues, and/or have spread to nearby lymph nodes in the neck. This includes most stage III, IVA, and IVB p16/HPV-negative cancers and most stage I, II, and III p16/HPV-positive cancers in the TNM system. HPV/p16 status directly determines which stage groupings apply to a given patient.

Treatment Approach — Partial Overview

Most locally advanced oropharyngeal cancers are treated with chemoradiation — radiation delivered concurrently with chemotherapy. Alternative approaches include giving chemotherapy as the initial treatment before radiation, or considering surgery as the first step when the cancer can be removed safely.

Full regimen details, sequencing, eligibility criteria, and specific agent selection are available in the complete protocol →

Instant Access to Structured Evidence-Based Regimens

References

  1. These are larger cancers in the back of the tongue, soft palate, and tonsils that have grown into nearby tissues, and/or have spread to nearby lymph nodes in the neck.
  2. In general, this includes most stage III, IVA, and IVB p16/HPV-negative cancers and most stage I, II, and III p16/HPV-positive cancers in the TNM system.
  3. Most locally advanced oropharyngeal cancers are treated with chemoradiation.
  4. Sometimes, chemo might be given as the first treatment, followed by radiation alone or chemoradiation, and then surgery if needed.
  5. Surgery might also be an option as the first treatment if the surgeon thinks the cancer can be removed safely.
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