Radiotherapy in HPV-Associated Oropharyngeal Cancer Patients

Fig. 1

NTCP values (risk on side effects) according to the 6 different approaches. CRT-70 current standard chemoradiation; BioRT-70 standard radiotherapy with cetuximab; CRT-56 reduced radiation dose chemoradiation; CPT-70 standard radiation dose concurrent IMPT; BioPT standard dose IMPT plus cetuximab; CPT-56 reduced-dose concurrent IMPT

5 Conclusion

Radiotherapy alone for HPV-associated OPC provides high locoregional control rates in well-selected cases with favorable prognostic factors and can be applied in particular when CRT is considered too toxic. Radiation-induced toxicity in HPV-associated OPC can be reduced with different de-escalation and detoxification strategies. When patients are treated with IMRT, the most promising de-escalation approach is reduced-dose IMRT after good response to induction chemotherapy, but this may come at the cost of some loss in locoregional control. With IMPT, the risk of radiation-induced side effects can be further reduced and might be considered in the future for intermediate-risk patients in which de-escalation is less preferable.

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