From the Guidelines

Treatment options for oropharyngeal cancers include surgery, radiation therapy, and concurrent systemic therapy.

Surgery: may be used as primary treatment for early-stage oropharyngeal cancers, including neck dissection as indicated 1
Radiation therapy: may be used as definitive treatment for early-stage oropharyngeal cancers, or as adjuvant therapy for locally advanced resectable disease 1
Concurrent systemic therapy: may be delivered to patients with T1-T2 N1 oropharyngeal cancer receiving definitive radiotherapy who are considered at particularly significant risk for locoregional recurrence, after a careful discussion of patient preferences and the limited evidence supporting its use 1

For locally advanced resectable disease, treatment approaches include:
- Concurrent systemic therapy/radiotherapy with cisplatin (category 1) 1
- Surgery with appropriate adjuvant therapy (chemo/radiotherapy or radiotherapy) 1
- Induction chemotherapy followed by radiotherapy or chemo/radiotherapy 1

HPV status: is a prognostic factor, and patients with HPV-related cancers should be enrolled in clinical trials evaluating biological and treatment-related questions 1
Adjuvant systemic therapy/RT: is recommended for patients with oropharyngeal cancer and extracapsular spread, based on randomized studies in which HPV status was unknown 1

From the Research

The treatment options for oropharyngeal cancer include:

Surgery: robotic surgery or open approaches with reconstructive flaps can be considered in advanced stages, resulting in the de-intensification of subsequent systemic therapy and fewer related side effects 2
Chemotherapy: can be used in combination with radiation therapy or surgery 2, 3
Radiation therapy: intensity modulated radiation therapy (IMRT) is a common treatment option, especially for early stage oropharyngeal cancer 4, 5, 6
Transoral robotic surgery (TORS): has been reported to result in similar survival and disease control outcomes as IMRT, but with different side effect profiles 4, 5
Transoral laser microsurgery (TLM): has also been used to manage oropharyngeal cancer, especially in early stages 3

The treatment choice for oropharyngeal cancer is influenced by several factors, including:

Tumor variability and prognostic factors 2
Cancer extension, extranodal extension, nervous invasion, and human papilloma virus (HPV) presence 2
HPV status: HPV-related oropharyngeal cancer is strongly associated with a favorable overall survival and disease-free survival rate, while HPV-negative oropharyngeal cancer often has a worse prognosis 2, 5, 6
Patient's overall health and preferences 4, 5

The management of oropharyngeal cancer is often multidisciplinary, involving a team of healthcare professionals, including: