Treatment of p16 (HPV)-Negative Squamous Cell Carcinoma of the Tonsil — Stage T1-2, N0-1

Clinical Scenario

This protocol addresses squamous cell carcinoma arising at the tonsil (oropharynx) in which p16 immunohistochemistry is negative, confirming HPV-negative tumor biology. The applicable staging is clinical T1–2, N0–1. HPV/p16 status is required testing at this anatomical site and directly determines which treatment pathway applies.

Treatment Approach (partial overview)

Management is built around single-modality treatment of both the primary site and the neck. Depending on the individual case, the approach may centre on surgical resection with regional neck management, definitive radiation therapy, or — for selected N1 disease — a concurrent systemic and radiation strategy. Adjuvant therapy may follow surgery when certain pathologic features are present.

Full regimen details, dosing, and sequencing available in the complete protocol →

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References

Base of Tongue/Tonsil/Posterior Pharyngeal Wall/Soft Palate
Tumor human papillomavirus (HPV) testing by p16 IHC required
p16-negative
T1–2, N0–1
Resection of primary and ipsilateral or bilateral neck dissection
Definitive RT
66 Gy (2.2 Gy/fraction) to 70 Gy (2.0 Gy/fraction); daily Monday–Friday in 6–7 weeks
For T1–2, N1 only: Concurrent systemic therapy/RT (category 2B)
Clinical trials

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