Oropharyngeal Carcinoma

Introduction

Oropharyngeal carcinoma (OPC) is a form of head and neck cancer. Cancer of the oropharynx can develop on the rear one-third of the tongue, the soft palate, the tonsils, and the back and side walls of the throat. Smoking, tobacco use and human papillomavirus (HPV) infection are among the major risk factors of developing oropharyngeal cancer.

Some symptoms of oropharyngeal cancer are prolonged sore throat, difficulty in swallowing, completely opening the mouth, or moving the tongue, weight loss for no apparent reason; ear aches; bumps in the back of the mouth, throat, or neck, a persistent white spot on the tongue or in the mouth and spitting up blood.

Prevalence

India has the highest number of mouth related cancer cases and accounts for almost one-third of the worldwide oral cancer burden. Every year, over 77,000 new cases and 52,000 fatalities are recorded in India, accounting for almost one-fourth of global occurrences. Because oral cancer is one of the most frequent kinds of cancer in India, the rising number of cases is a major issue for community health.

Scientific Data

Many studies have been conducted in the field of oropharyngeal cancer treatment with the application of various modalities, most prominently using tomotherapy and proton therapy. In a study carried forward by Blanchard et al Intensity modulated radiation therapy (IMRT) was compared with Intensity modulated proton therapy (IMPT) for OPC patients; it was noted that the IMPT group had lower rates of gastrostomy tube reliance and severe weight loss. Similarly, Sio et al found that IMPT had a lower patient-reported symptom burden than IMRT.

Furthermore, when the acute toxicity profiles of the two modalities are examined in a recent study by Yoon et al, the patients in the IMRT/IMPT combination group experienced considerably less commonly grade 3 mucositis and analgesic quantification algorithm ( AQA) score 3 ( i.e., strong opioid usage), respectively than patients treated with IMRT alone. The same tendencies were seen among following propensity matched analysis: the rates of grade 3 mucositis were 41.7% and 13.9%, respectively, and those of AQA score 3 were 50.0% and 25.0% for IMRT alone versus IMRT? IMPT combination.

Notwithstanding improving and advanced modalities of treatment like IMRT and IMPT IMPT being available, it is important to remember that prevention is better than cure. Interventions aimed at decreasing or eliminating tobacco and alcohol consumption and improving uptake of HPV vaccine are imperative.