Treatment of Locally Advanced, p16/HPV-Negative Squamous Cell Carcinoma of the Tonsil
This protocol covers squamous cell carcinoma (SCC) of the tonsil (oropharynx) in patients whose tumor tests negative for p16 by immunohistochemistry — indicating HPV-unrelated disease — at locally advanced clinical stages.
Clinical Scenario
This protocol applies when all of the following are confirmed:
- Site: tonsil (oropharynx) — includes base of tongue, posterior pharyngeal wall, soft palate
- Histology: squamous cell carcinoma
- p16 (HPV) immunohistochemistry: negative HPV-negative
- Clinical stage: T3–4a, N0–1 or T1–4a, N2–3
Treatment Approach
Management targets both the primary tumor and the neck through combined-modality treatment — typically centred on concurrent systemic therapy with radiotherapy, though the complete set of approaches and the decision algorithm are detailed in the full protocol.
References
- Base of Tongue/Tonsil/Posterior Pharyngeal Wall/Soft Palate
- Tumor human papillomavirus (HPV) testing by p16 IHC required
- p16-negative
- T3–4a, N0–1
- T1–4a, N2–3
- Concurrent systemic therapy/RT
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