An RPA-based TNM stage grouping (stage I/II/III: T1-3N0-N2b/T1-3N2c/T4 or N3, with M1 as stage IV) is proposed for HPV-related OPC as a result of significantly improved survival prediction compared with the seventh edition TNM, and prognostication is further improved by an RPA-based prognostic grouping within the American Joint Committee on Cancer/Union for International Cancer Control TNM framework for HPV-related OPC.

SBRT has an important role to play in treating early-stage NSCLC, particularly for medically inoperable patients with limited other treatment options. Shared decision-making with patients should be performed in all cases to ensure the patient understands the risks related to SBRT, the side effects, and the alternative treatments available.

BACKGROUND:The objective of this study was to investigate the prognostic value of the pretreatment circulating neutrophil count (CNC), circulating monocyte count (CMC), and circulating lymphocyte count (CLC) in human papillomavirus (HPV)-related (HPV1) and HPV-unrelated (HPV-) oropharyngeal cancer (OPC). METHODS: All p16-confirmed HPV1 and HPV-OPC cases treated with chemoradiotherapy from 2000 to 2010 were included. Overall survival (OS) and recurrence-free survival (RFS) were compared for high and low CNCs, CMCs, and CLCs (dichotomized by median values). A multivariate analysis (MVA) confirmed their prognostic value in HPV1 and HPV-tumors, respectively. RESULTS: Five hundred ten HPV1 OPC cases and 192 HPV-OPC cases were included. The HPV1 cohort had lower CNC and CMC values but a CLC similar to that of the HPV-patients (P <.01). The median follow-up was 4.8 years. In the HPV1 cohort, a high CNC or CMC correlated with reduced OS and RFS in comparison with a low CNC or CMC (P <.01 for all), but no difference was evident in OS (P 5.30) or RFS (P 5.10) with the CLC. MVA confirmed that a higher CNC or CMC independently predicted lower OS (hazard ratio [HR] for CNC, 1.14, P <.01; HR for CMC, 2.95, P <.01) and lower RFS (HR for CNC, 1.11, P <.01; HR for CMC, 3.39, P <.01), whereas a higher CLC was associated with higher RFS (HR, 0.66, P 5.03) and marginally higher OS (HR, 0.80, P 5.08). In the HPV-cohort, CNC, CMC, and CLC were not predictive of OS (P 5.16, P 5.86, and P 5.14) or RFS (P 5.61, P 5.59, and P 5.62). CONCLUSIONS: This relatively large cohort study demonstrates that a high CNC and a high CMC independently predict inferior OS and RFS, whereas a high CLC predicts better RFS and marginally better OS in HPV1 OPC patients. This association was not apparent in HPV-patients. Cancer 2015;121:545-55.

ORN is relatively uncommon among patients with oropharyngeal carcinoma who are treated with IMRT, but continues to occur beyond 5 years after treatment. Modifiable risk factors that are associated with higher rates of ORN include smoking and the use of bisphosphonates. Minimizing the volumes of the mandible receiving >50 Gy or > 60 Gy also may have an effect on the ORN rate. Cancer 2017;123:3691-3700. © 2017 American Cancer Society.