Induction chemotherapy followed by conversion surgery for p16-positive oropharyngeal carcinoma

Abstract

Human papillomavirus-induced oropharyngeal squamous cell carcinoma (p16+ OPC) is considered a unique disease entity. Despite highly successful clinical management using (chemo-) radiotherapy, late toxicities cause terrible distress to the patients. Reducing these complications and maintaining a good quality of life are crucial.A 64-year-old woman presented with complaints of a mass on the right side of the neck without pharyngeal symptoms. Positron emission tomography-computed tomography showed accumulation in the right tonsil. The oropharyngeal tumor and involved lymph node were biopsied, and p16-positive squamous cell carcinoma was diagnosed on histopathological analysis. Induction chemotherapy (ICT) was administered using intravenous docetaxel, cisplatin, and 5-fluorouracil. Subsequently, primary transoral resection and neck dissection were performed. The patient is alive with no pharyngeal complications 43 months postoperatively.Surgical intervention after ICT is attractive as a therapeutic strategy for reducing late toxicity. p16+ OPC may be potentially curable without the use of radiation.

Keywords

• Human papillomavirus positive oropharyngeal carcinoma
• p16
• Induction chemotherapy
• Conversion surgery
• Head
• Neck