Oropharyngeal cancer: Administration of Chemoradiation

Radiotherapy (RT)

Chemotherapy given with radiation

Acts as a radiosensitiser i.e. increases radiation-induced DNA damage
Increases radiation dose effect by 7-8 Gy
When chemotherapy is added to RT to treat OPC, there is an overall survival benefit of 5.3% at 5 years
Addition of chemotherapy gives an absolute benefit of 4.5% at 5 years
Addition of chemotherapy increases acute side-effects of RT – as well as adding unique toxicities
Addition of chemotherapy should not compromise ability of patient to complete RT
“Gold standard”: Single-agent, high-dose Cisplatin 3 weekly x 3 cycles *
Alternative regimens *
- Single-agent, high-dose Carboplatin 3 weekly x 3
- Single-agent, low-dose Cisplatin / Carboplatin weekly x 6
- Carboplatin & Paclitaxel 3 weekly x 3
- Cetuximab
- Hydroxyurea

Patients should be carefully selected for this treatment

Performance status 0 to 1, and at least fair nutrition
Normal / near-normal hearing especially if Cisplatin used
Normal renal function
Availability of supportive care: patients often need iv fluids / admission / feeding tubes / transfusions / antibiotics
Careful monitoring throughout as well after treatment to ensure patients regain pre-treatment weight, swallowing function etc.

- Performance status 0 to 1, and at least fair nutrition
- Normal / near-normal hearing especially if Cisplatin used
- Normal renal function
- Availability of supportive care: patients often need iv fluids / admission / feeding tubes / transfusions / antibiotics
- Careful monitoring throughout as well after treatment to ensure patients regain pre-treatment weight, swallowing function etc