How do you approach staging and treatment for a p16+ nasopharyngeal SCC?

Topics: Head and Neck Cancers • Radiation Oncology • Medical Oncology

How do you stage? Like nasopharynx or p16+ oropharynx?

Do you treat it like npx ca with chemo xrt + adj chemo or like opx p16+ with definitive chemo xrt . Would you use weekly chemo?

For radiation volume, do you include the oropharynx when treating p16+ NPX SCC?

Answer from: Radiation Oncologist at Academic Institution

First question is whether it is strictly p16 positive and confirmed EBER ISH negative. If so, I treat it like p16 positive oropharyngeal cancer with chemoradiation. I don't give adjuvant chemo. All the adjuvant chemo or induction chemo data is for EBER ISH positive nasopharyngeal carcinoma.

Comments

Radiation Oncologist at University of Texas MD Anderson Cancer Center
I agree that it should be approached like HPV-OPC....

Answer from: Radiation Oncologist at Academic Institution

Treat like nasopharynx with chemo RT. I’m not a fan of post RT adjuvant chemo.

Comments

Radiation Oncologist at Munson Medical Center
Just as a side note for LRC for HPV+ cases…...

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