Human Papillomavirus–Associated Oropharyngeal Cancer: Review of Current Evidence and Management

Abstract

Oropharyngeal cancer (opc) has become the leading site for human papillomavirus (hpv)–associated cancers in humans. It is an epidemic that remains relatively unfamiliar to most physicians, potentially delaying diagnosis and treatment. Traditionally, cancers involving the head and neck have occurred in smokers and in those with a significant alcohol history. Typically, hpv-positive opc presents in a younger, healthier population with a different set of risk factors and good prognosis for survival. However, many head-and-neck cancer patients, including those with hpv-positive disease, develop lifelong disabilities because of the morbid nature of their treatments, and those patients have the highest level of unmet needs in studies spanning cancer sites. Knowledge of this epidemic, a high index of suspicion, and an understanding of how the tumours present in clinical practice can help physicians to make an early diagnosis, thus sparing the patient significant morbidity from treatments associated with more advanced disease stages. Furthermore, recognizing that these patients have distinct psychosocial needs and implementing a collaborative team approach is critical to providing optimal care and improving quality of life in the survivorship period.

Modern treatment outcomes for early T-stage oropharyngeal cancer treated with intensity-modulated radiation therapy at a tertiary care institution

“…Concurrent chemoradiation with 3 cycles of high-dose cisplatin is currently the standard treatment for locoregionally advanced OPSCC [ 22 ]. However, due to short- and long-term toxicities, and due to the fact that HPV-associated OPSCC is more sensitive to chemotherapy and radiation than HPV-negative OPSCC, there has been much interest in treatment de-escalation [ 23 , 24 ].…”

Effects of a Multidisciplinary Residential Nutritional Rehabilitation Program in Head and Neck Cancer Survivors—Results from the NUTRI-HAB Randomized Controlled Trial

“…Compared to the remaining survey population, more trial participants were female (p = 0.032), and more were diagnosed with pharyngeal cancer, while fewer were diagnosed with oral or laryngeal cancer (p = 0.011, Appendix C, Table A4). A great proportion of pharyngeal cancers are related to human papillomavirus, and these individuals tend to have a higher socioeconomic status and less alcohol and tobacco abuse [63]. Hence, their symptom level and rehabilitation needs may differ from oral or laryngeal cancer survivors'.…”

G Protein-Coupled Receptor Genes, PTGDR1, PTGDR2, and PTGIR, Are Candidate Epigenetic Biomarkers and Predictors for Treated Patients with HPV-Associated Oropharyngeal Cancer

“…HPV is now established as the principal cause of increased incidence of an HNSCC subset in numerous geographic regions around the world [ 20 ]. HPV-associated OPC typically presents in a younger, healthier population with a different set of risk factors and good prognosis for survival [ 21 ]. However, several studies have demonstrated the risk stratification of patients with HPV-associated OPC based on tobacco smoking history as follows: low risk (HPV-associated, 10 pack years) and intermediate risk (HPV-associated, >10 pack years) [ 22 , 23 ].…”