Treatment Options for Metastatic and Recurrent Oropharyngeal Cancer

Surgical resection, if technically feasible and the tumor does not respond to radiation therapy.[1]

Radiation therapy, if the tumor is not completely removed by surgery and curative doses of radiation have not been given previously.[2]

A second surgery, if the tumor was not completely removed initially and if technically feasible.[1]

Chemotherapy, for unresectable locoregionally recurrent disease.

Additional radiation therapy using conventionally fractionated radiation therapy, or hyperfractionated radiation therapy (HFX) with concurrent chemotherapy.[3]

Stereotactic body radiation therapy with concurrent cetuximab.[4]

Immunotherapy (inhibitor of the programmed death-ligand 1 [PD-L1] pathway) can be used after platinum-based chemotherapy failure [5,6] or up front in patients with metastatic or locally recurrent disease.[7,8]

Clinical trials evaluating additional radiation therapy using HFX with concurrent chemotherapy, targeted therapy, stereotactic body radiation therapy, or immunotherapy.[9]