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Cancer Research and Treatment > Accepted Articles
doi: https://doi.org/10.4143/crt.2020.973    [Accepted]
Recent Treatment Patterns of Oropharyngeal Cancer in Korea Based on the Expert Questionnaire Survey of the Korean Society for Head and Neck Oncology (KSHNO)
Kye Hye Choi1, Jin Ho Song1, Yeon-Sil Kim1, Ji-hoon Kim2, Woo-Jin Jeong3, Inn-Chul Nam4, Jin Ho Kim5, Hee Kyung Ahn6, Sang Hoon Chun7, Hyun Jun Hong8, Young-Hoon Joo9, Young-Gyu Eun10, Sung Ho Moon11, Jeong Shim Lee12
1Department of Radiation Oncology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
2Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
3Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
4Department of Otolaryngology-Head and Neck Surgery, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
5Department of Radiation Oncology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
6Division of Medical Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
7Division of Medical Oncology, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
8Department of Otorhinolaryngology-Head and Neck Surgery, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea
9Department of Otolaryngology-Head and Neck Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
10Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea
11Proton Therapy Center, Research Institute and Hospital, National Cancer Center, Goyang, Korea
12Department of Radiation Oncology, Inha University Hospital, Inha University of Medicine, Incheon, Korea
Correspondence  Yeon-Sil Kim ,Tel: 82-2-2258-6259, Fax: 82-2-592-1532, Email: yeonkim7@catholic.ac.kr
Received: September 25, 2020;  Accepted: January 26, 2021.  Published online: January 29, 2021.
ABSTRACT
Purpose
The incidence of human papillomavirus (HPV)-related oropharyngeal cancer (OPC) has increased, and staging and optimal therapeutic approaches are challenging. A questionnaire survey was conducted to investigate the controversial treatment policy of stage T2 OPC according to the N category and determine the opinions of multidisciplinary experts in Korea.
Materials and Methods
Five OPC scenarios were developed by the Subcommittee on Oropharyngeal Treatment Guidelines of the Korean Society for Head and Neck Oncology and distributed to experts of multidisciplinary treatment hospitals.
Results
Sixty-five experts from 45 institutions responded. For the HPV-positive T2N0M0 scenario, 67.7% of respondents selected surgery followed by definitive concurrent chemoradiotherapy (CCRT) or radiotherapy alone. For the T2N1M0 HPV-positive scenario, there was a notable difference in the selection of primary treatment by expert specialty; 53.9% of respondents selected surgery and 39.8% selected definitive CCRT as the primary treatment. For the T2N3M0 advanced HPV-positive scenario, 50.0% of respondents selected CCRT and 33.3% considered induction chemotherapy (IC) as the primary treatment. CCRT and IC were significantly more frequently selected for the HPV-related OPC cases (p=0.010). The interdepartmental variability showed that the head and neck surgeons and medical oncologists favored surgery, whereas the radiation oncologists preferably selected definitive CCRT (p < 0.001).
Conclusion
In this study, surgery was preferred for lymph node-negative OPC, and as lymph node metastasis progressed, CCRT tended to be preferred, and IC was administered. Clinical practice patterns by stage and HPV status showed differences according to expert specialty. Multidisciplinary consensus guidelines will be essential in the future.
Key words: Oropharyngeal neoploasms, Treatment patterns, Human papillomavirus, Questionnaire study
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