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

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.

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