Survey of radiation field and dose in human papillomavirus positive oropharyngeal cancer: is de-escalation actually applied in clinical practice?

• 발행기관: 대한방사선종양학회
• 저자명: Kyu Hye Choi Jin Ho Song Yeon-Sil Kim Sung Ho Moon Jeongshim Lee Young-Taek Oh Dongryul Oh Jin Ho Kim Jun Won Kim
• 간행물 정보: 『대한방사선종양학회지』제39권 제3호, 174~183쪽, 전체 10쪽
• 주제분류: 의약학 > 종양학
• 파일형태: PDF
• 발행일자: 2021.09.30

영문 초록

Purpose: Studies on de-escalation in radiation therapy (RT) for human papillomavirus-positive (HPV(+)) oropharyngeal cancer (OPC) are currently ongoing. This study investigated the current practice regarding the radiation dose and field in the treatment of HPV(+) OPC. Materials and Methods: The Korean Society for Head and Neck Oncology conducted a questionnaire on the primary treatment policy. Among them, for HPV(+) OPC scenarios, radiation oncologists were questioned regarding the field and dose of RT. Results: Forty-two radiation oncologists responded to the survey. In definitive concurrent chemoradiotherapy (CCRT) treatment for stage T2N1M0 OPC, most respondents prescribed a dose of >60 Gy to the primary tonsil and involved ipsilateral lymph nodes. However, eight of the respondents prescribed a relatively low dose of ≤54 Gy. For stage T2N1M0 OPC, postoperative adjuvant RT was prescribed by eight and nine respondents with a lower dose of ≤50 Gy for the ipsilateral tonsil and involved neck, respectively. In definitive CCRT in complete remission after induction chemotherapy for initial stage T2N3M0 OPC, de-escalation of the tonsil and involved neck were performed by eight and seven respondents, respectively. Regarding whether de-escalation is applied in radiotherapy for HPV(+) OPC, 27 (64.3%) did not do it at present, and 15 (35.7%) were doing or considering it. Conclusion: The field and dose of prescribed treatment varied between institutions in Korea. Among them, dose de-escalation of RT in HPV(+) OPC was observed in approximately 20% of the respondents. Consensus guidelines will be set in the near future after the completion of ongoing prospective trials.

목차

Introduction

Materials and Methods

Results

Discussion and Conclusion

Conflict of Interest

Acknowledgments

References

키워드

Oropharyngeal neoplasms Human papillomavirus Radiotherapy De-escalation