Executive summary

This review article summarized the clinical evidence of proton therapy in treating HPV-related oropharyngeal squamous cell carcinoma (OPSCC), including results from the latest randomized trial that PT is non-inferior to IMRT for tumor control while reducing treatment-related toxicities, such as feeding tube dependence (28 % vs. 42 %, p = 0.019) and facilitating better work resumption outcomes (71 % vs. 52 % at 2 years). However, up to 70 % of locoregional recurrences occur in-field, PT may improve local regional control while minimizing toxicity. PT could also play a role in the reirradiation of recurrent OPSCC, with reported 1-year LRC rates of 71.8-80.8 %, 2-year LRC rates of 72.8-80.3 %, 1-year OS of 65.2-81.3 %, 2-year OS of 32.7-69 %, and late grade 2 toxicities of 11.9-36.3 %. 

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