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Therapy Testing in a Spheroid-based 3D Cell Culture Model for Head and Neck Squamous Cell Carcinoma
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Variation in Practice Patterns Among Radiation Oncologists Treating Oropharyngeal Cancers.

Morgan Bailey1, Jonathan Sackett, Hope Esslinger

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Radiation oncologists show varied approaches to treating HPV-mediated oropharyngeal cancers, impacting clinical trial design and patient care. This highlights a need for standardized treatment protocols in head and neck oncology.

Keywords:
consensushead and neckoropharyngeal cancer

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Head and Neck Cancer

Background:

  • Human papillomavirus (HPV)-mediated oropharyngeal cancers (OPX) have a favorable prognosis.
  • Therapeutic de-escalation strategies are being explored for HPV+ OPX.
  • Understanding current practice patterns is crucial for designing future clinical trials.

Purpose of the Study:

  • To survey expert head and neck (H&N) radiation oncologists regarding their practice patterns for OPX cancer treatment.
  • To identify variations in radiation planning and treatment delivery for HPV-mediated and HPV-negative OPX.
  • To inform the design of future clinical trials investigating de-escalation of therapy for HPV+ OPX.

Main Methods:

  • A survey was distributed to H&N radiation oncologists treating at least 12 noncutaneous H&N cancer cases annually.
  • The survey consisted of 25 questions administered via an anonymous RedCap link.
  • Results were analyzed using RedCap statistics and chi-squared (χ2) tests.

Main Results:

  • Fifty-five H&N radiation oncologists participated, representing 41 institutions.
  • Most physicians administer definitive radiation doses of 69.96 or 70 Gy.
  • Significant variation exists in CTV expansion (average 3.6 mm) and postoperative radiation doses for HPV+ OPX, with differing indications for chemotherapy.

Conclusions:

  • There is considerable variation and a lack of consensus in radiation planning for OPX cancers across institutions.
  • This variability may negatively influence resident training and patient outcomes.
  • Standardization of treatment protocols is needed to improve consistency and efficacy in HPV+ OPX management.