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Treatment of locoregionally advanced (stage III and IV) head and neck cancer: The oropharynx

Francis P Worden, MD
Carol R Bradford, MD, FACS
Avraham Eisbruch, MD
Section Editors
Marshall R Posner, MD
Bruce E Brockstein, MD
David M Brizel, MD
Marvin P Fried, MD, FACS
Deputy Editor
Michael E Ross, MD


Oropharyngeal squamous cell carcinomas originate in the soft palate, tonsils, base of tongue, pharyngeal wall, or the vallecula, the fold located between the base of tongue and the epiglottis (figure 1) [1]. Oropharyngeal cancer is a relatively uncommon malignancy, with approximately 100,000 cases of oropharyngeal cancer diagnosed worldwide each year, which cause death in at least half of cases [2].

The tumor, node, metastasis (TNM) staging system of the American Joint Committee on Cancer (AJCC) and the Union for International Cancer Control (UICC) is used to stage oropharyngeal cancer. In the eighth edition of the AJCC TNM staging system, separate staging systems have been established for HPV associated oropharyngeal carcinoma (figure 2 and table 1A and table 1B) and for HPV negative oropharyngeal cancer (table 2 and table 3) [3,4] (see "Overview of the diagnosis and staging of head and neck cancer"). The eighth edition AJCC staging system will go into effect in the United States in 2018, and this section will be updated. Comments in this section still apply to seventh edition AJCC unless otherwise noted.

The treatment of locally advanced, stage III to IVB cancers of the oropharynx will be reviewed here. The treatment of early stage oropharyngeal cancer is discussed separately, as is the management of patients with distant metastases (stage IVC).

(See "Treatment of early (stage I and II) head and neck cancer: The oropharynx", section on 'General principles'.)

(See "Treatment of metastatic and recurrent head and neck cancer".)

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Literature review current through: Nov 2017. | This topic last updated: Sep 11, 2017.
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