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Optimizing Radiotherapy in HPV-Associated Oropharyngeal Cancer Patients

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HPV Infection in Head and Neck Cancer

Part of the book series: Recent Results in Cancer Research ((RECENTCANCER,volume 206))

Abstract

Concurrent chemoradiation is considered the golden standard in the treatment of locally advanced OPC. However, given the very high survival rates in favorable HPV-positive OPC and the high rates of acute and late treatment-related side effects, de-escalation strategies have to be considered. In this chapter, the potential benefit of a number of de-escalation strategies is described, including of replacement of concurrent chemotherapy by cetuximab, radiation dose de-escalation based on response to induction chemotherapy, radiotherapy alone without systemic treatment, and limiting elective nodal target volumes for radiation. In addition to de-escalation, modern radiation technologies like protons will offer increasing opportunities to decrease the dose to normal tissues in order to prevent radiation-induced toxicities. Initial analysis showed that radiation dose de-escalation based on response to induction chemotherapy in combination with intensity-modulated proton therapy (IMPT) has the highest potential to decrease acute and late toxicities.

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Authors and Affiliations

  1. Department of Radiation Oncology, University Medical Center Groningen, Groningen, The Netherlands

    Johannes A. Langendijk

  2. University of Groningen, Groningen, The Netherlands

    Roel J.H.M. Steenbakkers

Authors
  1. Johannes A. Langendijk
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  2. Roel J.H.M. Steenbakkers
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Corresponding author

Correspondence to Johannes A. Langendijk .

Editor information

Editors and Affiliations

  1. Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznań, Poland

    Wojciech Golusiński

  2. Department of Otolaryngology-Head and Neck Surgery, VU University Medical Center/Cancer Center Amsterdam, Amsterdam, The Netherlands

    C. René Leemans

  3. Dept. of Head Medicine and Oral Health, University of Leipzig Clinic of Otolaryngology, Leipzig, Germany

    Andreas Dietz

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© 2017 Springer International Publishing Switzerland

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Langendijk, J.A., Steenbakkers, R.J. (2017). Optimizing Radiotherapy in HPV-Associated Oropharyngeal Cancer Patients. In: Golusiński, W., Leemans, C., Dietz, A. (eds) HPV Infection in Head and Neck Cancer. Recent Results in Cancer Research, vol 206. Springer, Cham. https://doi.org/10.1007/978-3-319-43580-0_12

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  • DOI: https://doi.org/10.1007/978-3-319-43580-0_12

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43578-7

  • Online ISBN: 978-3-319-43580-0

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