2016_Head & Neck COURSE BOOK

Oropharynx Cancer

Surgery versus RT for T1-2N0-1

Con Surgery

Pro -RT

– Morbidity of composite resection – SND / RT for neck

– Mostly single modality – Easy elective neck treatment

Pro Surgery

• Con RT/CRT

– Morbidity is limited if surgery is transorally (TORS/CO2) – SND gives pathology of neck – Possible to withhold RT in about 50% or decrease dosage – Keep RT for unfavorable cases and second primaries/recurrences

– Once a lifetime – Costs / duration – Salvage surgery has poor results – Long term toxicity • CVA (5-7x)

• Fibrosis/xerostomia/ nerve dysfunctioning