Indian clinical practice consensus guidelines for the management of oropharyngeal cancer: Update 2022

Author:

Noronha Vanita1,Prabhash Kumar1,Babu K Govind2,Chaturvedi Pankaj3,Kuriakose Moni4,Birur Praveen5,Anand Anil K6,Kaushal Ashish7,Mahajan Abhishek8,Syiemlieh Judita9,Singhal Manish10,Gairola Munish11,Ramachandra Prakash12,Goyal Sumit13,John Subashini14,Nayyar Rohit15,Patil Vijay M16,Rao Vishal17,Roshan Vikas18,Rath G.K.19

Affiliation:

1. Departments of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra

2. Department of Medical Oncology, HCG Hospitals, Bangalore, Karnataka

3. Surgical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra

4. Department of Head and Neck Surgery – Oncology, Mazumdar Shaw Medical Center, NH Health City, Bangalore, Karnataka

5. Department of Oral Medicine and Radiology, KLE Society's Institute of Dental Sciences (KLESIDS), Bangalore, Karnataka

6. Department of Radiation Oncology, Fortis Memorial Research Institute, Gurugram, Haryana

7. Department of Medical Oncology, HCG Cancer Centre, Ahmedabad, Gujarat

8. Department of Radiology, The Clatterbridge Cancer Centre, NHS Foundation Trust, Liverpool, United Kingdom

9. Department of Radiation Oncology, Civil Hospital, Shillong, Meghalaya

10. Department of Medical Oncology, Indraprastha Apollo Hospital, New Delhi, Delhi

11. Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, Delhi

12. Department of Radiation Oncology, Sri Shankara Cancer Hospital and Research Centre, Bangalore, Karnataka

13. Department of Medical Oncology, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, Delhi

14. Department of Radiotherapy, Christian Medical College, Vellore, Tamil Nadu

15. Department of Surgical Oncology, Max Super Speciality Hospital, New Delhi, Delhi

16. Department of Medical Oncology, P D Hinduja Hospital, Mumbai, Maharashtra

17. Department of Surgical Oncology, HCG Cancer Centre, Bangalore, Karnataka

18. Department of Radiation Oncology, Shri Mata Vaishno Devi Narayana Super Speciality Hospital, Jammu, Jammu and Kashmir

19. Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, Delhi

Abstract

The aim of oropharyngeal cancer treatment should be to treat the disease while preserving speech and swallowing abilities. Early-stage disease is generally treated with surgery/radiotherapy (RT). A combination of chemotherapy and RT should be considered instead of RT alone for patients with locally advanced disease. Patients with locally advanced resectable disease can be treated with transoral or open resection of the primary + ipsilateral/bilateral neck dissection ± adjuvant chemoradiotherapy (CTRT)/adjuvant RT. In unresectable locally advanced disease, sequential induction chemotherapy (TPF [docetaxel, cisplatin, fluorouracil]) followed by locoregional treatment with RT or CTRT can be considered. Adding targeted therapies like nimotuzumab to cisplatin-based CTRT in locally advanced head-and-neck squamous cell carcinoma improves the progression-free survival, locoregional control, and disease-free survival without negatively impacting the quality of life.

Publisher

Medknow

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