[Comment] De-escalation of adjuvant radiotherapy in HPV-associated oropharyngeal cancer

HPV-associated oropharyngeal carcinoma has a distinct biology and responds favourably to primary radiation (and surgery)-based treatments. The long-term survival benefit is, however, offset by chronic detrimental impact on health-related quality of life for cancer survivors due to treatment-related toxic effects such as dysphagia and xerostomia. Consequently, many toxicity-mitigating de-escalation methods are being explored for HPV-associated oropharyngeal carcinoma.1 Minimally invasive primary transoral surgery followed by de-intensification of post-operative (chemo) radiation depending on pathological risk assessment is one such investigational approach.