The number of new cases of oropharyngeal cancer is increasing year by year among the world, and HPV infection is one of the risk factors for this malignant tumor. Compared with HPV-negative oropharyngeal cancer, HPV-positive patients are more sensitive to radiotherapy and have a better prognosis, but there is no accepted treatment for HPV-positive patients. Reducing treatment intensity moderately and exploring the best option to minimize side effects of treatment are urgent issues to be addressed. This article reviews the research progress on the treatment improvement of HPV-associated oropharyngeal cancer in recent years.
Humans ; Papillomavirus Infections ; Oropharyngeal Neoplasms/therapy* ; Risk Factors

OBJECTIVE: To analyze the survival rates and quality of life of human papillomaviruse (HPV)-negative patients with advanced oropharyngeal cancer after different combined treatments with chemotherapy, surgery and radiotherapy. METHODS: We retrospectively analyzed the data of patients with oropharyngeal cancer hospitalized in our hospital from January, 2015 to December, 2020, and after case analysis of the clinical, imaging and pathological data, 405 patients were included in this study and grouped according to the treatments they received. Kaplan-Meier and Log-rank analysis were used to calculate the overall survival rate and the survival rate of patients with different treatments. The self-rated quality of life of the tumor-free survivors was assessed using UW-QOL (4) questionnaire and compared among the patients with different treatments. RESULTS: Among the 405 patients included in this study, 146 received treatments with chemotherapy+surgery+radiotherapy (CSRT), 138 received surgery+radiotherapy (SRT) and 121 were treated with radiotherapy+chemotherapy (RCT). The overall survival rates of the 3 groups at 1, 3 and 5 years were 85.1%, 67.1% and 56.9%, respectively, and the survival rates of patients receiving CSRT, SRT and RCT did not differ significantly (P > 0.05). A total of 280 UW-QOL (4) questionnaires were distributed and 202 (72.14%) were retrieved. The average total scores decreased in the order of CSRT > SRT > RCT; the scores were significantly higher in CSRT group than in SRT and RCT (P < 0.05), but did not differ significantly between SRT and RCT groups (P > 0.05). CONCLUSION CSRT, SRT and RCT are all treatment options for locally advanced oropharyngeal cancer, but CSRT may achieve better quality of life of the patients than SRT and RCT.
Alphapapillomavirus ; Humans ; Oropharyngeal Neoplasms/therapy* ; Quality of Life ; Retrospective Studies ; Survival Rate

The multidisciplinary approach to treat squamous cell carcinoma of the head and neck cancer is evolving and complex. Induction chemotherapy has been used in resectable disease for organ preservation, and has shown similar survival when compared with concurrent chemoradiotherapy. Thus, concurrent cisplatin-based chemoradiotherapy is considered as standard treatment for organ preservation for larynx, hypopharynx, and oropharynx cancers. Given that recent evidence of survival benefits with taxane-containing combination chemotherapy for induction chemotherapy, the concept of induction chemotherapy followed by concurrent chemotherapy is being revised. Also, with advances in molecular biology of cancer, a new molecular targeted agent, epidermal growth factor inhibitor (EGFR) antagonist such as EGFR monoclonal antibody showed promising results in the treatment of patients with both locoregionally advanced and metastatic squamous cell carcinoma of the head and neck cancer. Trials with incorporation of this agent are ongoing. In this article, some recent advances in the treatment of squamous cell carcinoma of the head and neck cancer, in particular the expanding role of chemotherapy in organ preservation will be reviewed.
Carcinoma, Squamous Cell ; Chemoradiotherapy ; Drug Therapy ; Drug Therapy, Combination ; Epidermal Growth Factor ; Head and Neck Neoplasms* ; Head* ; Humans ; Hypopharynx ; Induction Chemotherapy ; Larynx ; Molecular Biology ; Organ Preservation* ; Oropharyngeal Neoplasms

Oropharyngeal carcinoma is one of the most common malignant tumors of head and neck. In recent years, the incidence of Human papilloma virus-associated oropharyngeal squamous cell carcinoma（HPV-OPSCC） has been increasing year by year. With the advancement of minimally invasive surgical techniques, the wide application of intensity modulated radiation therapy, and the demand of patients for organ function protection and higher quality of life, the unique biological behavior and better prognosis of HPV-OPSCC have led to the exploration of a series of attenuated treatment modes. This article reviews the diagnosis and treatment status of oropharyngeal cancer and related research progress based on relevant reports.
Humans ; Papillomavirus Infections/diagnosis* ; Quality of Life ; Squamous Cell Carcinoma of Head and Neck/therapy* ; Head ; Human Papillomavirus Viruses ; Oropharyngeal Neoplasms/therapy* ; Head and Neck Neoplasms

PURPOSE: We tried to evaluate the role of conventional radiotherapy alone or with neoadjuvant chemotherapy in oropharyngeal cancerin terms of survival rates and to identify prognostic factors affecting survival by retrospective analysis. METHODS AND MATERIALS: Forty seven patients of oropharyngeal cancer were treated by conventional radiotherapy in our hospital from Nov. 1985 to Apr.1993. Of these. twenty six patients were treated by conventional radio therapy alone. and 21 patients with neoadjuvant chemotherapy of mostly two or more cycles of cisplatin and pepleomycin. The patient characteristics of radiotherapy alone group and neoadjuvant chemotherapy group were not different generally. Radiotherapy was performed by 6MV-LINAC and the total radiation doses of primary tumors were 54.0-79.2 Gy and cervical lymph nodes were 55.8-90.0 Gy with a fraction size of 1.8 or 2.0 Gy per day. The rangeof follow-up periods was 3-102 months and median was 20 months. The range of age was 33-79 years old and median was 58 years old. RESULTS: Overall 3-year actuarial survival rate (3YSR) of all patients was 39%. The 3YSRs of stage I (n=5), II (n=11), III (n=12) and IV (n=19) were 60, 55,33 and 32% respectively. The 3YSRs of T1+2, T3+4 and No, N+ were 55, 18% (p=0.005) and 43,36% (p>0.1), respectively. There was no difference in 3YSRs between radiotherapy alone group and neoadjuvant chemotherapy group (38 vs 43%, p>0.1). According to the original site of primary tumor, the 3YSRs of tonsil (n=32), base of tongue (n=8), soft palate or uvula(n=6) and pharyngeal wall (n=1) were 36,38,67 and 0%, respectively. The patients of soft palateor uvular cancer had longer survival than other primaries but the difference was not significant statistically (p>0.1). Of 32 patients of tonsillar cancer, 22 patients who had primary extension to adjacent tissue showed inferior survival rate to the ones who had not primary extension, but the difference was marginally significant (24 vs 60%, p=0.08). On Cox multivariate analysis in entire patients with variables of age. T stage. N stage. total duration of radiotherapy, the site of primary tumor and the use of neoadjuvant chemotherapy. only T stage was a significant prognostic factor affecting 3YSR. CONCLUSION: The difference of 3YASRs of conventional radiotherapy alone group and neoadjuvant chemotherapy group was not significant statistically. These treatments could be effective in oropharyngeal cancer of early stage, especially such as soft palate, uvular or tonsillar cancer which did not extend to adjacent tissue. But in order to improve the survival of patients of most advanced oropharyngeal caner, other altered fractionated radiotherapy such as hyperfractionation rather than conventional fractionation or multimodel approach combining radiotherapy and accessible surgery or concurrent chemotherapy might be beneficial.
Cisplatin ; Drug Therapy ; Follow-Up Studies ; Humans ; Lymph Nodes ; Middle Aged ; Multivariate Analysis ; Oropharyngeal Neoplasms* ; Palate, Soft ; Palatine Tonsil ; Peplomycin ; Radiotherapy* ; Retrospective Studies ; Survival Rate ; Tongue ; Tonsillar Neoplasms

NK/T-cell lymphoma, which often shows an angiocentric growth pattern, is a distinct clinicopathologic entity highly associated with Epstein-Barr virus. The disease is characterized by a destruction of the upper respiratory tract, particularly the nasal cavity, palate and paranasal sinuses. Interestingly, NK/T-cell lymphoma is closely linked to a variety of complications, such as hemophagocytic syndrome, second primary cancer, sepsis and bleeding. Here we report a case of a 50-year-old man diagnosed initially as NK/T-cell lymphoma of the oropharynx and who developed a second primary carcinoma of the hard palate during combination chemotherapy and radiation therapy.
Carcinoma, Squamous Cell/*pathology/therapy ; Case Report ; Combined Modality Therapy ; Fatal Outcome ; Human ; Killer Cells, Natural ; Lymphoma, T-Cell/*pathology/therapy ; Male ; Middle Age ; Neoplasms, Second Primary/*pathology/therapy ; Oropharyngeal Neoplasms/*pathology/therapy ; Palatal Neoplasms/*pathology/therapy

PURPOSE: We investigated the prognostic factors for distant metastasis (DM) in patients with locally advanced oropharyngeal cancer (OPC) treated with surgery and adjuvant radiotherapy with or without concurrent chemotherapy. MATERIALS AND METHODS: Eighty-five patients treated between January 1995 and August 2014 were evaluated retrospectively. Data regarding the pathological tumour and nodal status, human papillomavirus (HPV) status, treatment characteristics, and pretreatment maximum standardized uptake value (SUVmax) of 18-fluoro-2-deoxyglucose positron emission tomography–computed tomography scan (¹⁸F-FDG PET-CT) were evaluated, and their influence on DM and survival outcomes were analyzed. RESULTS: Median follow-up period was 48.0 months. Recurrence was observed in 20 patients, including locoregional recurrence and DM. DM was observed in 13 patients. A multivariate analysis confirmed that the presence of lymphovascular invasion (p=0.031), lower neck lymph node (LN) involvement (p=0.006), SUVmax ≥ 9.7 (p=0.014), and tumour size ≥ 3 cm (p=0.037) significantly affected DM. HPV status was not associated with DM. Perineural invasion (p=0.048), lower neck LNinvolvement (p=0.008), SUVmax ≥ 9.7 (p=0.019), and tumour size ≥ 3 cm (p=0.033) were also significant factors for the DM-free survival rate. CONCLUSION: Lower neck LN involvement, high SUVmax in pretreatment ¹⁸F-FDG PET-CT, and large tumour size were predictive factors for DM in patients of OPC.
Drug Therapy* ; Electrons ; Follow-Up Studies ; Humans ; Lymph Nodes ; Multivariate Analysis ; Neck ; Neoplasm Metastasis* ; Oropharyngeal Neoplasms* ; Radiotherapy* ; Radiotherapy, Adjuvant ; Recurrence ; Retrospective Studies ; Survival Rate

We herein report a witnessed cardiopulmonary collapse of a patient with difficult mask ventilation and near-impossible laryngoscopy-cum-intubation in the critical care unit. The airway was successfully rescued with a laryngeal mask airway Supreme™, followed by an open, crash tracheostomy by the otolaryngologist.
Airway Management ; methods ; Critical Care ; Heart Arrest ; therapy ; Humans ; Laryngeal Masks ; Larynx ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Oropharyngeal Neoplasms ; diagnosis ; Trachea ; surgery ; Tracheostomy ; Treatment Outcome

Follicular dendritic sarcoma is a rare and low-grade malignant soft tissue tumors , often occurs in the lymph nodes, we report a case of tonsil follicular dendritic sarcoma which occured after Non-Hodgkin's lymphoma had be cured. The chief complaint was oropharyngeal foreign body sensation with hemoptysis three years, found in the left neck mass increased with more than 4 months. The left side of the pharyngeal wall thickening and disappearance of parapharyngeal space with the surrounding lymph nodes extremely enlarged and integrated was demonstrated by the contrast-enhanced CT of neck. Finally,the pathological diagnosis was tonsil follicular dendritic sarcoma.
Female ; Humans ; Lymph Nodes ; pathology ; Lymphoma, Non-Hodgkin ; therapy ; Neck ; Oropharyngeal Neoplasms ; diagnostic imaging ; pathology ; Palatine Tonsil ; diagnostic imaging ; pathology ; Radiography ; Sarcoma ; diagnostic imaging ; pathology

BACKGROUND AND OBJECTIVES: Surgery with postoperative radiotherapy has been the standard treatment for locally advanced head and neck squamous cell carcinoma (HNSCC). However, the prognosis still remains dismal. To increase survival rate and organ preservation rate, alternative approach is needed. Incorporating the taxane regimen into the treatment of HNSCC, the new treatment strategy of sequential therapy has been introduced. The purpose of this study is to determine the efficacy of neoadjuvant chemotherapy, followed by concurrent chemoradiotherapy for the HNSCC. SUBJECTS AND METHOD: Between January 2001 and June 2005, 19 patients with HNSCC were treated with neoadjuvant chemotherapy, followed by concurrent chemoradiotherapy. The sites of primary tumors were hypopharynx in eight patients, oropharynx in six patients, and larynx in five patients. Neoadjuvant chemotherapy included 70 mg/m2 of docetaxel on day 1, 70 mg/m2 of cisplantin on day 2 and 800 mg/m2 of 5-fluorouracil on day 2-4. The cycles were repeated every three weeks. Concurrent chemoradiotherapy starts after two cycles of neoadjuvant chemotherapy. Radiation dose was 200 cGy/dayx5/week with a total of 6,000-7,000 cGy, and the concurrent chemotherapy of 20 mg/m2 of docetaxel or 20 mg/m2 of cisplantin was given weekly. RESULTS: The median follow-up was 21 months. The overall 2-year survival rate was 70.1% and the 2-year organ preservation rate was 59.4%. The survival rate and organ preservation rate of larynx cancer patients were higher than those of hypopharynx and oropharynx cancer patients, but it was not statistically significant (p=0.09, 0.16). The patients of the lower stage showed higher survival rate and organ preservation rate, but it was not statistically significant (p=0.19, 0.48). The most common Grade 3 or 4 toxicities of neoadjuvant chemotherapy were leukopenia, anorexia, nausea and vomiting, whereas the most common Grade 3 or 4 toxicities during concurrent chemoradiotherapy were mucositis, stomatitis, and leukopenia. One patient died due to sepsis during treatment. CONCLUSION: Neoadjuvant chemotherapy with three combined regimens followed by concurrent chemoradiotherapy might be effective treatment modality for HNSCC. Further studies with large number of patients and longer follow-up will be needed.
Anorexia ; Carcinoma, Squamous Cell* ; Chemoradiotherapy ; Drug Therapy* ; Fluorouracil ; Follow-Up Studies ; Head and Neck Neoplasms ; Head* ; Humans ; Hypopharynx ; Laryngeal Neoplasms ; Larynx ; Leukopenia ; Mucositis ; Nausea ; Neck* ; Neoadjuvant Therapy ; Organ Preservation ; Oropharyngeal Neoplasms ; Oropharynx ; Prognosis ; Radiotherapy ; Sepsis ; Stomatitis ; Survival Rate ; Vomiting