Re-I Chin1, Christopher R Spencer2, Todd DeWees2, Michael Y Hwang3, Pranav Patel1, Parul Sinha4, Hiram A Gay2, Bruce H Haughey4,5, Brian Nussenbaum4, Douglas R Adkins6, James S Lewis7,8, Wade L Thorstad9. 1. Saint Louis University School of Medicine, St. Louis, Missouri. 2. Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri. 3. Rutgers New Jersey Medical School, Newark, New Jersey. 4. Department of Otolaryngology Head and Neck Surgery, Washington University School of Medicine, St. Louis, Missouri. 5. Department of Surgery, University of Auckland School of Medicine, Auckland, New Zealand. 6. Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri. 7. Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri. 8. Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, TN. 9. Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri. wthorstad@radonc.wustl.edu.
Abstract
BACKGROUND: The purpose of this study was to compare outcomes of patients with p16-positive oropharyngeal squamous cell carcinoma (SCC) treated with postoperative intensity-modulated radiotherapy (IMRT) before and after an institutional dose reduction policy effective on February 2009. METHODS: Between 1998 and 2013, 175 consecutive patients with p16-positive oropharyngeal SCC with extracapsular extension (ECE) and/or close or positive margins were treated postoperatively to 66 Gy (n = 109) or 60 Gy (n = 66) in 2 Gy/fx. RESULTS: Between the 66 and 60 Gy groups, there was no difference in tumor classification (pT4 vs pT1-T3; p = .181) and nodal classification (pN2c-N3 vs pN0-N2b; p = .704), and American Joint Committee on Cancer (AJCC) group stage (IV vs I-III; p = .473). Median follow-up was 5.9 years overall (66 Gy: 7.4 years; 60 Gy: 4.0 years). There was no difference in locoregional recurrence-free survival (2-year: 98.1% vs 98.5%; p = .421). CONCLUSION: This study suggests that treating p16-positive oropharyngeal SCC with ECE and/or close or positive margins with postoperative IMRT to 60 Gy may not compromise locoregional recurrence-free survival compared to 66 Gy.
BACKGROUND: The purpose of this study was to compare outcomes of patients with p16-positive oropharyngeal squamous cell carcinoma (SCC) treated with postoperative intensity-modulated radiotherapy (IMRT) before and after an institutional dose reduction policy effective on February 2009. METHODS: Between 1998 and 2013, 175 consecutive patients with p16-positive oropharyngeal SCC with extracapsular extension (ECE) and/or close or positive margins were treated postoperatively to 66 Gy (n = 109) or 60 Gy (n = 66) in 2 Gy/fx. RESULTS: Between the 66 and 60 Gy groups, there was no difference in tumor classification (pT4 vs pT1-T3; p = .181) and nodal classification (pN2c-N3 vs pN0-N2b; p = .704), and American Joint Committee on Cancer (AJCC) group stage (IV vs I-III; p = .473). Median follow-up was 5.9 years overall (66 Gy: 7.4 years; 60 Gy: 4.0 years). There was no difference in locoregional recurrence-free survival (2-year: 98.1% vs 98.5%; p = .421). CONCLUSION: This study suggests that treating p16-positive oropharyngeal SCC with ECE and/or close or positive margins with postoperative IMRT to 60 Gy may not compromise locoregional recurrence-free survival compared to 66 Gy.
Authors: Brett A Miles; Marshall R Posner; Vishal Gupta; Marita S Teng; Richard L Bakst; Mike Yao; Kryzsztof J Misiukiewicz; Raymond L Chai; Sonam Sharma; William H Westra; Seunghee Kim-Schulze; Bheesham Dayal; Stanislaw Sobotka; Andrew G Sikora; Peter M Som; Eric M Genden Journal: Oncologist Date: 2021-03-18
Authors: Virginie Achim; Rachel K Bolognone; Andrew D Palmer; Donna J Graville; Tyler J Light; Ryan Li; Neil Gross; Peter E Andersen; Daniel Clayburgh Journal: JAMA Otolaryngol Head Neck Surg Date: 2018-01-01 Impact factor: 6.223