Surgery alone for transorally resected human papillomavirus-driven head and neck cancer-can we de-intensify adjuvant therapy to 0 Gy and 0 mg/m2 ?

Although smoking has traditionally been the dominant causative factor of head and neck cancer, cancers of the tonsils and base of tongue increasingly are being driven by human papillomavirus, and these cancers are easier to cure. When radiation is used as the primary curative treatment, a number of studies have shown good outcomes with reduced doses of both radiation and chemotherapy. New techniques that access the tumor through the mouth instead of the jaw have made surgery dramatically less toxic. Outcomes are favorable, and many patients traditionally given radiation and chemotherapy afterward may be able to safely omit them.