Head and Neck TumorsHead and Neck TumorsОпухоли головы и шеи2222-14682411-4634Publishing House ABV Press77210.17650/2222-1468-2022-12-2-108-115REVIEWОБЗОРНАЯ СТАТЬЯTreatment strategy for HPV-positive oropharyngeal cancer: a literature reviewСтратегия лечения ВПЧ-положительного рака ротоглотки: обзор литературыhttps://orcid.org/0000-0002-2283-1812SaprinaO. A.СапринаО. А.
Russian Federation

Oksana A. Saprina.

23 Kashirskoe Shosse, Moscow 115478.

Саприна Оксана Александровна.

115478 Москва, Каширское шоссе, 24.

isabekian@mail.ruN.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of RussiaНациональный медицинский исследовательский центр онкологии им. Н.Н. Блохина Минздрава России010820221221081153107202231072022Copyright ©; 2022, Saprina O.A.Copyright ©; 2022, Саприна О.А.2022Saprina O.A.Саприна О.А.https://creativecommons.org/licenses/by/4.0https://ogsh.abvpress.ru/jour/article/view/772

This review presents data on the strategy for the treatment of oropharyngeal cancer associated with human papillomavirus. This pathology occurs mainly in young people without bad habits. Despite the low degree of differentiation, the course of the disease is relatively favorable. In addition, the tumor has a rather high sensitivity to conservative methods of treatment. The article discusses various options for de-escalation of therapy, modern drug regimens, as well as the results of the most significant randomized trials on this issue.

В данном обзоре представлены данные о стратегии лечения рака ротоглотки, ассоциированного с вирусом папилломы человека. Данная патология возникает преимущественно у лиц молодого возраста без вредных привычек. Несмотря на низкую степень дифференцировки, течение заболевания является относительно благоприятным. К тому же опухоль обладает довольно высокой чуствительностью к консервативным методам лечения. В статье рассматриваются различные варианты деэскалации терапии, современные схемы лекарственного лечения, а также результаты наиболее значимых рандомизированных исследований, посвященных данной проблеме.

human papillomavirus-associated oropharyngeal cancerp16-positive oropharyngeal cancersquamous cell carcinomatreatment deescalationchemoradiotherapyрак ротоглоткиассоциированный с вирусом папилломы человекар16-положительный орофарингеальный ракплоскоклеточный ракдеэскалация леченияхимиолучевое лечениеDavydov M.I. Encyclopedia of clinical oncology. Moscow: RADAR-2004, 2004. (In Russ.).Давыдов М.И. Энциклопедия клинической онкологии. М.: РЛС-2004, 2004.NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). Cancer of the Oropharynx. Version 2.2018. Available at: https://www.nccn.org/guidelines/category_1.Ragin C.C.R., Taioli E. Survival of squamous cell carcinoma of the head and neck in relation to human papillomavirus infection: review and meta-analysis. Int J Cancer 2007;121(8):1813-20. DOI: 10.1002/ijc.22851Allen C.T., Lewis J.S., El-Mofty S.K. et al. Human papillo- mavirus and oropharynx cancer: biology, detection and clinical implications. Laryngoscope 2010;120(9):1756-72. DOI: 10.1002/lary.20936.Allen C.T., Lewis J.S., El-Mofty S.K. et al. Human papillomavirus and oropharynx cancer: biology, detection and clinical implications. Laryngoscope 2010;120(9):1756-72. DOI: 10.1002/lary.20936.O'Sullivan B., Huang S.H., Su J. et al. Development and validation of a staging system for HPV-related oropharyngeal cancer by the International Collaboration on Oropharyngeal cancer Network for Staging (ICON-S): a multicentre cohort study. Lancet Oncol 2016;17(4):440-510. DOI: 10.1016/S1470-2045(15)00560-4.Chaturvedi A.K., Engels E.A., Anderson W.F., Gillison M.L. Incidence trends for human papillomavirus-related and -unrelated oral squamous cell carcinomas in the United States. J Clin Oncol 2008;26:612-9.Chaturvedi A.K., Engels E.A., Pfeiffer R.M. et al. Human papillomavirus and rising oropharyngeal cancer incidence in the United States. J Clin Oncol 2011;29(32):4294-301. DOI: 10.1200/JCO.2011.36.4596.Corey A.S., Hudgins P.A. Radiographic imaging of human papillomavirus related carcinomas of the oropharynx. Head Neck Pathol 2012;6(Suppl. 1):S25-40. DOI: 10.1007/s12105-012-0374-3.D'Souza G., Agrawal Y., Halpern J. et al. Oral sexual behaviors associated with prevalent oral human papillomavirus infection. J Infect Dis 2009;199(9): 1263-9. DOI: 10.1086/597755.D'Souza G., Zhang H.H., D'Souza W.D. et al. Moderate predictive value of demographic and behavioral characteristics for a diagnosis of HPV16-positive and HPV16-negative head and neck cancer. Oral Oncol 2010;46(2):100-4. DOI: 10.1016/j.oraloncology.2009.11.004.Vokes E.E., Agrawal N., Seiwrt T.Y. HPV-associated head and neck cancer. J Natl Cancer Inst 2015;107(12):djv344. DOI: 10.1093/jnci/djv344.Ang K.K., Harris J., Wheeler R. Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med 2010;363(1):24-35. DOI: 10.1056/NEJMoa0912217.Harrison L.B., Sessions R.B., Kies M.S. Head and neck cancer. A multidisciplinary approach. 2014. 4th edn. Lippincott Williams and Wilkins, Philadelphia, USA.Nguyen-Tan P.F., Zhang Q., Ang K.K. et al. Ran- domized phase III trial to test accelerated versus standard fractionation in combination with concurrent cisplatin for head and neck carcinomas in the Radiation Therapy Oncology Group 0129 trial: long-term report of efficacy and toxicity. J Clin Oncol 2014;32(34):3858-66. DOI: 10.1200/JCO.2014.55.3925.Nguyen-Tan P.F., Zhang Q., Ang K.K. et al. Randomized phase III trial to test accelerated versus standard fractionation in combination with concurrent cisplatin for head and neck carcinomas in the Radiation Therapy Oncology Group 0129 trial: long-term report of efficacy and toxicity. J Clin Oncol 2014;32(34):3858-66. DOI: 10.1200/JCO.2014.55.3925.Chera B.S., Amdur R.J., Tepper J.E. et al. Mature results of a prospective study of deintensified chemoradiotherapy for low-risk human papillomavirus-associated oropharyngeal squamous cell carcinoma. Cancer 2018;124(11):2347-54. DOI: 10.1002/cncr.31338.Chera B.S., Amdur R.J., Green R. et al. Phase II trial of de-intensified chemoradiotherapy for human papillomavirus-associated oropharyngeal squamous cell carcinoma. J Clin Oncol 2019;37(29): 2661-9. DOI: 10.1200/JCO.19.01007.Marur S., Li S., Cmelak A.J. et al. E1308: phase II trial of induction chemotherapy followed by reduced-dose radiation and weekly cetuximab in patients with HPV-associated resectable squamous cell carcinoma of the oropharynx -ECOG-ACRIn Cancer Research Group. J Clin Oncol 2016;35(5):490-7. DOI: 10.1200/JCO.2016.68.3300.Cmelak A., Li S., Marur S. et al. Symptom reduction from IMRT dose deintensification: Results from ECOG 1308 using the Vanderbilt Head and Neck Symptom Survey version 2 (VHNSS V2). J Clin Oncol 2015;33(15 suppl):6021a.Misiukiewicz K., Gupta V., Miles B.A. et al. Standard of care vs reduced-dose chemoradiation after induction chemotherapy in HPV+ oropharyngeal carcinoma patients: The Quarterback trial. Oral Oncol 2019;95:170-7. DOI: 10.1016/j.oraloncology.2019.06.021.Seiwert T.Y., Foster C.C., Blair E.A. et al. OPTIMA: a phase II dose and volume deescalation trial for human papillomaviruspositive oropharyngeal cancer. Ann Oncol 2019;30(2):297-302. DOI: 10.1093/annonc/mdy522.Nevens D., Duprez F., Daisne J.F. et al. Reduction of the dose of radiotherapy to the elective neck in head and neck squamous cell carcinoma; a randomized clinical trial. Effect on late toxicity and tumor control. Radiother Oncol 2017;122(2):171-7. DOI: 10.1016/j.radonc.2016.08.009.Nevens D., Duprez F., Daisne J.-F. et al. Recurrence patterns after a decreased dose of 40Gy to the elective treated neck in head and neck cancer. Radiother Oncol 2017;123(3):419-23. DOI: 10.1016/j.radonc.2017.03.003.Al-Mamgani A., van Werkhoven E., Navran A. et al. Contralateral regional recurrence after elective unilateral neck irradiation in oropharyngeal carcinoma: a literature-based critical review. Cancer Treat Rev 2017;59:102-8. DOI: 10.1016/j.ctrv.2017.07.004.Jellema A.P., Slotman B.J., Doornaert P. et al. Unilateral versus bilateral irradiation in squamous cell head and neck cancer in relation to patient-rated xerostomia and sticky saliva. Radiother Oncol 2007;85(1):83-9. DOI: 10.1016/j.radonc.2007.03.002.Loganadane G., Kelly J.R., Lee N.C. et al. Incidence of radiographically occult nodal metastases in HPV+ oropharyngeal carcinoma: Implications for reducing elective nodal coverage. Pract Radiat Oncol 2018;8(6):397-403. DOI: 10.1016/j.prro.2018.03.009.Leeman J.E., Gutiontov S., Romesser P. et al. Sparing of high retropharyngeal nodal basins in patients with unilateral oropharyngeal carcinoma treated with intensity modulated radiation therapy. Pract Radiat Oncol 2017;7(4):254-9. DOI: 10.1016/j.prro.2016.11.002.Tam M., Riaz N., Kannarunimit D. et al. Sparing bilateral neck level IB in oropharyngeal carcinoma and xerostomia outcomes. Am J Clin Oncol 2015;38(4):343-7. DOI: 10.1097/COC.0000000000000064.Mohindra P., Urban E., Pagan J.D. et al. Selective omission of level V nodal coverage for patients with oropharyngeal cancer: clinical validation of intensity-modulated radiotherapy experience and dosimetric significance. Head Neck 2016;38(4):499-505. DOI: 10.1002/hed.23924.Rosenberg A.J., Agrawal N., Pearson A. et al. Low risk HPV-associated oropharyngeal squamous cell carcinoma treated with induction chemoimmunotherapy followed by TORS or radiotherapy. Multidisciplinary Head Neck Cancers Symposium; February 27-29, 2020; Scottsdale, AZ.Garden A.S., Morrison W.S., Stugis E.M. et al. IMRT for oropharyngeal carcinoma: patiet outcome and patterns of failure. Int J Radiat Oncol Biol Phys 2011;81(2): 15-6. DOI: 10.1016/j.ijrobp.2011.06.031.Pernot M., Luporsi E., Hoffstetter S. et al. Complications following definitive irradiation for cancers of the oral cavity and the oropharynx (in a series of 1134 patients). Int J Radiat Oncol Biol Phys 1997;37(3):577-85. DOI: 10.1016/s0360-3016(96)00612-8.Henstrom D.K., Moore E.J., Olsen K.D. et al. Transoral resection for squamous cell carcinoma of the base of the tongue. Arch Otolaryngol Head Neck Surg 2009;135(12):1231-8. DOI: 10.1001/archoto.2009.177.De Almeida J.R., Byrd J.K., Wu R. et al. A systematic review of transoral robotic surgery and radiotherapy for early oropharynx cancer. Laryngoscope 2014;124(9):2096-102. DOI: 10.1002/lary.24712.Moore E.J., Olsen S.M., Laborde R.R. et al. Long-term functional and oncologic results of transoral robotic surgery for oropharyngeal squamous cell carcinoma. Mayo Clin Proc Mayo Clin 2012;87(3):219-25. DOI: 10.1016/j.mayocp.2011.10.007.Smith R.V., Schiff B.A., Garg M. et al. The impact of transoral robotic surgery on the overall treatment of oropharyngeal cancer patients. Laryngoscope 2015;125(10):S10-5. DOI: 10.1002/lary.25534.Grant D.C., Hinni M.L., Salassa J.R. et al. Oropharyngeal cancer: a case of single modality with transoral laser microsurgery. Arch Otolaryngol Head Neck Surg 2009;135(12):1225-30. DOI: 10.1001/archoto.2009.185.Haughey B.H., Hinni M.I., Salassa J.R. et al. Transoral laser microsurgery as primary treatment for advanced stage oropharyngeal cancer: a Unated States multicenter study. Head Neck 2011;33(12):1683-94. DOI: 10.1002/hed.21669.Moore E.J., Olsen S.M., Laborde R.R. et al. Long-term functional and oncologic results of transoral robotic surgery for oropharyngeal squamous cell carcinoma. Mayo Clin Proc Mayo Clin 2012;87(3):219-25. DOI: 10.1016/j.mayocp.2011.10.007.Steiner W., Fierek O., Ambrosch P. et al. Transoral laser microsurgery for squamous cell carcinoma of the base of the tongue. Arch Otolaryngol Head Neck Surg 2003;129(1):36-43. DOI: 10.1001/archotol.129.1.36.Mirghani H., Blanchard P. Treatment de-escalation for HPV-driven oropharyngeal cancer: where do we stand? Clin Transl Radiat Oncol 2018;8:4-11. DOI: 10.1016/j.ctro.2017.10.005.Ferris R.L., Flamand Y., Weinstein G.S. et al. Transoral robotic surgical resection followed by randomization to low- or standard-dose IMRT in resectable p16+ locally advanced oropharynx cancer: a trial of the ECOG-ACRIn Cancer Research Group (E3311). J Clin Oncol 2020;38(15 suppl):6500a.Ma D.J., Price K.A., Moore E.J. et al. Phase II evaluation of aggressive dose de-escalation for adjuvant chemoradiotherapy in human papillomavirus-associated oropharynx squamous cell carcinoma. J Clin Oncol 2019;37(22):1909-18. DOI: 10.1200/JCO.19.00463.Sinha P., Lewis J.S., Piccirillo J.F. et al. Extracapsular spread and adjuvant therapy in human papillomavirus-related, p16-positive oropharyngeal carcinoma. Cancer 2012;118(14):3519-30. DOI: 10.1002/cncr.26671