ARLINGTON, Va., June 18, 2024 — The American Society for Radiation Oncology (ASTRO) published today an updated clinical guideline that details best practices for using radiation therapy to treat patients who have oropharyngeal squamous cell carcinoma (OPSCC) caused by the human papillomavirus (HPV). Recommendations address radiation therapy as a standalone curative treatment or in combination with surgery and/or chemotherapy. The guideline also covers treatment planning and response assessment for patients diagnosed with this increasingly common type of head and neck cancer. The guideline is available as a free-access article in Practical Radiation Oncology, ASTRO’s clinical practice journal.

HPV-positive OPSCC, which occurs in a patient’s throat, is the most common type of HPV-associated cancer among men, and second only to cervical cancer in women. At least 70% of newly diagnosed oropharyngeal cancers are related to HPV. Since ASTRO published its last guideline for oropharyngeal cancer in 2017, HPV-positive OPSCC was recognized as a clinically separate disease from non-HPV OPSCC; the new guideline focuses specifically on treatment for patients with HPV-positive disease.

In contrast to decreasing incidence of tobacco- and alcohol-related OPSCC, incidence rates of HPV-related OPSCC are increasing rapidly in most developed nations, including the U.S., where approximately 21,000 adults are diagnosed with this type of cancer each year. Projections estimate that the number of people who have HPV-positive OPSCC will continue to rise over the next several decades before eventually decreasing as HPV vaccines become more globally accessible and their full impact is achieved.

People diagnosed with HPV-positive OPSCC tend to be younger — in the U.S., the average age at diagnosis is 55 — and often experience much better outcomes than those with HPV-negative disease. Radiation therapy is an especially effective treatment for tumors caused by HPV, which are more radiosensitive and typically more responsive to treatment. With the increasing number of long-term survivors, modern clinical trials tend to focus on de-escalating treatments to reduce side effects while maintaining high cure rates.

"Radiation therapy plays a critical role in the treatment of HPV-positive oropharyngeal cancer, offering a highly effective option for patients seeking curative outcomes. This updated guideline underscores the importance of tailored radiation strategies that maximize patient survival while minimizing side effects,” said Danielle N. Margalit, MD, MPH, vice chair of the guideline task force and a radiation oncologist at Brigham & Women’s/Dana-Farber Cancer Center in Boston. “The recommendations are informed by recent clinical trial data, providing a robust evidence base that empowers physicians and patients to make treatment decisions.”

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