Proton beams are big guns against HPV-related oropharyngeal cancers

Radiation oncologists are using protons against a growing number of oropharyngeal cancers caused by the human papilloma virus (HPV).

“We’re seeing a decrease in smoking-related head and neck cancers and an increase in HPV-related oropharyngeal cancers,” said Alexander Lin, MD, clinical operations director at Penn Medicine’s Roberts Proton Therapy Center in Philadelphia, Pennsylvania. Penn Medicine is the branded name for the University of Pennsylvania Health System.

Dr. Lin’s observation echoed a national report published last year in The Journal of the National Cancer Institute. Accumulating data also suggest that HPV-associated oropharyngeal cancers will surpass HPV-associated cervical cancers by 2020.

“This is where protons have the potential to improve cancer outcomes,” Dr. Lin said. “We expect otherwise healthy men and women in their 40s and 50s with HPV cancers will have up to a 90 percent chance of being cured and will be able to live a good quality of life, cancer-free, for many years.”

At the University of Pennsylvania Health System, the approach to treatment of advanced HPV-associated oropharyngeal cancers is a combined effort of initial surgery followed by radiation.

“Penn has one of the preeminent head and neck surgery departments in the world,” Dr. Lin said. “They have pioneered a technique using a robotic, transoral approach (TransOral Robotic Surgery-TORS), that allows for a much less invasive surgery compared to traditional approaches. This equates to better functional outcomes for patients, less time needed for recovery, and the ability to offer surgery to patients who otherwise would not have been candidates with traditional approaches.”

Radiation therapy is often used after surgery to further improve the odds of long-term cure. Chemotherapy may also be used as a follow-up treatment to surgery.

“We currently use proton therapy for patients who have undergone surgery for tonsil or base of tongue cancers,” Dr. Lin said, “and are currently developing techniques that will allow us to offer proton therapy to patients with other types of head and neck cancer, and those who are not able to undergo surgery.”