Even a palliative dose of radiotherapy can bring long-term survival in HPV+ locoregionally advanced squamous cell carcinoma of the oropharynx

The treatment of HPV-positive, human papillomavirus-induced squamous cell carcinoma of the head and neck (HNSCC) is the daily bread of radiation oncologists worldwide. Due to the increasing incidence of infection with this virus, elderly or frail patients who are unable to undergo radical oncological treatment are also being treated. Therefore, radiation oncologists are forced to choose suboptimal treatment strategies where the probability of local control of the tumor and cure rate are significantly reduced. These strategies include for example palliative radiotherapy targeted on tumor foci without irradiation of elective lymph node areas and without the addition of concurrent, radiotherapy-enhancing treatments (chemotherapy, hyperthermia etc.). Shorter radiotherapy regimens with lower doses, often half that of radical treatment, are commonly chosen. This article aims to show and confirm the truth of the data on a better prognosis of patients with HPV-associated HNSCC of the oropharynx where often even a lower (palliative) dose of radiotherapy leads to a long-term locoregional control of the disease and survival. To underline this fact we present one interesting case report.

Keywords: HPV positive head and neck cancers, importance of HPV positivity of HNSCC for patients, treatment methods, palliative dose of radiotherapy, toxicity of irradiation.