Otorhinolaryngology Head and Neck Surgery Department, Son Espases University Hospital, Palma de Mallorca, Spain.
Radiation Oncology Department, Son Espases University Hospital, Palma de Mallorca, Spain.
Oral Oncol. 2021 Feb;113:105111. doi: 10.1016/j.oraloncology.2020.105111. Epub 2020 Dec 16.
Human papillomavirus is responsible of approximately 70% oropharyngeal tumours and is related with more favourable outcomes. It has led to an increasing interest for de-escalation treatment strategies such as Trans Oral Robotic Surgery (TORS). A literature review was performed searching for the role of TORS as de-escalation modality of treatment in patients with p16 positive oropharyngeal squamous cell carcinoma (OPSCC). Special attention was paid to the potential advantage offered by TORS in reducing adjuvant radiation therapy. Six questions were formulated. 67 studies were selected. Several trials analysing the role of upfront TORS to treat early stage p16+ OPSCC and the possibility of reducing the adjuvant radiotherapy were founded. A lot of studies based on the experience of single centres show promising results. Nevertheless to date no definitive data can be extrapolated. The continued investigation of this line of de-escalation therapy with randomized prospective clinical trials is needed.
人乳头瘤病毒（HPV）可导致约 70%的口咽肿瘤，且与更有利的预后相关。这使得人们对降级治疗策略（如经口机器人手术（TORS））产生了浓厚的兴趣。我们进行了文献综述，以研究 TORS 作为 p16 阳性口咽鳞状细胞癌（OPSCC）患者治疗降级手段的作用。特别关注 TORS 在减少辅助放疗方面提供的潜在优势。提出了 6 个问题，共筛选出 67 项研究。有几项试验分析了 TORS 在治疗早期 p16+ OPSCC 以及减少辅助放疗可能性方面的作用。许多基于单中心经验的研究显示出了有前景的结果。然而，目前还无法推断出确切的数据。需要通过随机前瞻性临床试验继续研究这种降级治疗策略。
