09-12, 14:30–15:00 (Europe/Istanbul), Head & Neck Surgery 3
Background: HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) exhibits a markedly better prognosis than HPV-negative disease, prompting interest in treatment de-escalation to reduce long-term toxicity without compromising survival. Multiple prospective trials are evaluating approaches to tailor treatment intensity based on individual risk profiles.
Methods: This review summarizes current de-escalation strategies in HPV-positive OPSCC, including reduced-dose radiation, omission or minimization of concurrent chemotherapy, and primary surgical approaches such as transoral robotic surgery (TORS). Major clinical trials, including NRG-HN002, ECOG-ACRIN 3311, PATHOS, and ORATOR, were analyzed for oncologic outcomes, toxicity profiles, and patient-reported quality of life.
Results: Several studies demonstrate that de-escalated regimens—such as 60 Gy radiation with or without chemotherapy, or TORS followed by risk-adapted adjuvant therapy—achieve comparable locoregional control and overall survival to standard treatment, with improved functional outcomes. Importantly, patient selection is critical, relying on factors such as tumor stage, nodal burden, smoking history, and pathological features. Ongoing trials are refining risk stratification tools and assessing biomarkers for therapy individualization.
Conclusions: De-escalation strategies for HPV-positive OPSCC represent a paradigm shift toward more personalized, less morbid therapy. While early-phase studies show promising results, mature data from phase III trials are needed to define safe standards of care. Careful patient selection and multidisciplinary coordination remain essential to ensure oncologic efficacy while improving long-term quality of life.
To review and evaluate current evidence supporting treatment de-escalation strategies in HPV-positive OPSCC, with the goal of identifying approaches that maintain oncologic efficacy while minimizing long-term treatment-related toxicity, and to highlight ongoing research that aims to refine patient selection and risk stratification for personalized therapy.
The presentation aims to:
Explain why de-escalation is important for HPV-positive oropharyngeal cancer.
Present the current clinical strategies being tested or used (e.g., reduced radiation, TORS, selective chemotherapy).
Share outcomes from recent and ongoing trials.
Emphasize the importance of appropriate patient selection.
Discuss future directions and research needs to safely implement these strategies in clinical practice.
Professor Paweł Golusiński, MD, PhD, Professor of Medical and Health Sciences
Professor Paweł Golusiński is a distinguished Polish otolaryngologist and head and neck surgeon, currently directing the Department of Otolaryngology and Maxillofacial Surgery at the University of Zielona Góra and leading the ENT teams at both the University Hospital in Zielona Góra and St. Adalbert’s Hospital in Poznan
Education & Academic Titles: He earned his medical degree and PhD from the Poznań Medical University, followed by a habilitation at the Medical University of Silesia in Katowice. In August 2023, he was awarded the title of full Professor of Medical and Health Sciences by the President of Poland .
Specialist Training & Fellowships: Professor Golusiński completed an advanced fellowship in Head and Neck Oncology and Thyroid Surgery at Queen Elizabeth University Hospital in Birmingham. He is also a scholar of the Research Fellowship at VU University Amsterdam.
Clinical and Research Focus: His expertise spans head and neck cancer surgery, thyroid and parathyroid procedures, endoscopic sinus surgery. He conducts internationally collaborative research on HPV-related head and neck cancers, novel biomarkers, and minimally invasive transoral approaches. He serves as Editor and reviewer for multiple high impact journals.
Recognition & Credentials: He holds international certification in coblation and Bizact techniques. Professor Golusiński is a recipient of awards from the Polish Society of Otolaryngologists and the Rector’s Medal from Poznań Medical
Professor Golusiński combines surgical excellence, academic leadership, and a global training perspective to advance patient care, education, and research in otolaryngology.