Upfront transoral robotic surgery (TORS) versus intensity-modulated radiation therapy (IMRT) in HPV-positive oropharyngeal cancer: real-world data from a tertiary comprehensive cancer centre

• Published in: Acta otorhino-laryngologica italica Vol. 42; no. 4; pp. 334 - 347
• Main Authors: Zorzi, Stefano Filippo, Agostini, Giovanni, Chu, Francesco, Tagliabue, Marta, Pietrobon, Giacomo, Corrao, Giulia, Volpe, Stefania, Marvaso, Giulia, Colombo, Francesca, Cossu Rocca, Maria, Gandini, Sara, Gaeta, Aurora, Ruju, Francesca, Alterio, Daniela, Ansarin, Mohssen
• Format: Journal Article
• Language: English
• Published: Pacini Editore Srl 01.08.2022
• Subjects: Head and Neck
• ISSN: 1827-675X; 0392-100X; 1827-675X
• DOI: 10.14639/0392-100X-N2144

ObjectiveThis study aims to provide real-world data on oncologic and functional outcomes of the most modern surgical and non-surgical treatments of locally advanced HPV-positive oropharyngeal cancer. MethodsWe reviewed data on patients treated for stage III and IV HPV-positive oropharyngeal squamous cell carcinoma with either endoscopic surgery (Transoral Robotic Surgery, TORS; Transoral Laser Microsurgery, TLM - group A) or intensity-modulated radiotherapy (IMRT - group B). The minimum follow-up required was 6 months. Survival outcomes and toxicities of treatments were evaluated. Results30 patients in group A and 66 in group B were eligible for the analysis. 28% of patients in group A underwent a unimodal treatment, while 42% needed trimodal treatment. 90% of patients in group B underwent concurrent chemoradiation. We found no statistically significant difference in survival outcomes (group A: overall survival 97%, progression-free survival 83%; group B: OS 98%, PFS 86%) or toxicities between groups. ConclusionsBoth transoral surgery and IMRT provide excellent outcomes in HPV-positive oropharyngeal cancer. Because of the good prognosis, treatments need to be refined to reduce toxicities while preserving oncologic soundness.