Smoking and alcohol consumption remain the two most important risk factors for the
development of oropharyngeal tumours, but there is an increasing number of younger
patients (age <50 years) with human papillomavirus (HPV) association origin, also
known as positivity. The role of radiotherapy (RT) in the treatment of this disease
is paramount.To describe the radiotherapy results for oropharyngeal tumours and to
search for prognostic parameters that influence the response of these malignant lesions
to radio-chemotherapy.95 patients underwent definitive radio- or radio-chemotherapy
(RCT) for histologically squamous cell, oropharyngeal carcinoma at our Institute between
1 January 2019 and 31 December 2020, of which 51 (54%) received the latter. The mean
age was 61.9 years (37-82 years) and the male-female ratio was 69:26. The average
total dose was 69 Gy (range: 54-70 Gy).The 5-year local control (LC), cancer-specific
survival (CCS), and overall survival (OS) calculated by the Kaplan-Meier method were
71, 69, and 58%, respectively. Forty-four cases (46%) were confirmed to have HPV involvement.
HPV positive (+) tumours showed significantly better behaviour compared to HPV negative
(-) cases in LC, CCS and OS. Smoking had a significant negative effect on cure rates:
LC, CCS and OS were better in non-smokers. A significant negative effect of smoking
on survival was also observed in HPV-associated cases. For HPV- lesions, RCT had a
stronger effect on LC than RT alone (64 vs 43%, P = 0.03).HPV-associated malignancies
show better survival outcomes to radio ± chemotherapy than their HPV- counterparts.
In all cases, smoking worsens the response to treatment. For HPV- tumours, chemotherapy
with radiation, compared to irradiation alone, has a more significant effect on survival
outcomes, whereas for HPV+ tumours this effect is less pronounced.
