S Meade1, P Gaunt2, A Hartley3, M Robinson4, V Harrop1, J Cashmore1, L Wagstaff5, J Babrah2, S J Bowden2, H Mehanna5, P Sanghera6. 1. Hall-Edwards Radiotherapy Research Group, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK. 2. CRUK Clinical Trials Unit, University of Birmingham, Birmingham, UK. 3. Hall-Edwards Radiotherapy Research Group, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK; Institute of Head and Neck Studies and Education (InHANSE), University of Birmingham, Birmingham, UK. 4. School of Dental Sciences, Newcastle University, Newcastle, UK. 5. Institute of Head and Neck Studies and Education (InHANSE), University of Birmingham, Birmingham, UK. 6. Hall-Edwards Radiotherapy Research Group, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK; Institute of Head and Neck Studies and Education (InHANSE), University of Birmingham, Birmingham, UK. Electronic address: paul.sanghera@uhb.nhs.uk.
Abstract
AIMS: Oropharyngeal squamous cell carcinoma (OPSCC) can be divided into favourable and poor prognostic groups by association with human papilloma virus (HPV) and smoking. This study prospectively investigated a dose-intensified schedule in poor/intermediate prognosis OPSCC. MATERIALS AND METHODS: Patients with p16/HPV-negative or p16-positive N2b OPSCC with a greater than 10 pack-year smoking history were eligible. Patients were planned to receive 64 Gy in 25 fractions with cisplatin. The primary end point was absence of grade 3 mucositis at 3 months. RESULTS: Fifteen patients were recruited over 14 months. All patients completed a minimum of 2 years of follow-up. All patients completed full-dose radiotherapy within a median treatment time of 32 days (31-35). Grade 3 mucositis was absent in all patients at 3 months. There was one grade 4 toxicity event due to cisplatin (hypokalaemia). Complete response rates at 3 months were 100% and 93% for local disease and lymph nodes, respectively. One patient developed metastatic disease and subsequently died. Overall survival at 2 years was 93% (95% confidence interval 61-99%). CONCLUSIONS: The schedule of 64 Gy in 25 fractions with concomitant chemotherapy is tolerable in patients with poor and intermediate prognosis OPSCC.
AIMS: Oropharyngeal squamous cell carcinoma (OPSCC) can be divided into favourable and poor prognostic groups by association with human papilloma virus (HPV) and smoking. This study prospectively investigated a dose-intensified schedule in poor/intermediate prognosis OPSCC. MATERIALS AND METHODS:Patients with p16/HPV-negative or p16-positive N2b OPSCC with a greater than 10 pack-year smoking history were eligible. Patients were planned to receive 64 Gy in 25 fractions with cisplatin. The primary end point was absence of grade 3 mucositis at 3 months. RESULTS: Fifteen patients were recruited over 14 months. All patients completed a minimum of 2 years of follow-up. All patients completed full-dose radiotherapy within a median treatment time of 32 days (31-35). Grade 3 mucositis was absent in all patients at 3 months. There was one grade 4 toxicity event due to cisplatin (hypokalaemia). Complete response rates at 3 months were 100% and 93% for local disease and lymph nodes, respectively. One patient developed metastatic disease and subsequently died. Overall survival at 2 years was 93% (95% confidence interval 61-99%). CONCLUSIONS: The schedule of 64 Gy in 25 fractions with concomitant chemotherapy is tolerable in patients with poor and intermediate prognosis OPSCC.
Authors: Shao Hui Huang; Brian O'Sullivan; Jie Su; Jolie Ringash; Scott V Bratman; John Kim; Ali Hosni; Andrew Bayley; John Cho; Meredith Giuliani; Andrew Hope; Anna Spreafico; Aaron R Hansen; Lillian L Siu; Ralph Gilbert; Jonathan C Irish; David Goldstein; John de Almeida; Li Tong; Wei Xu; John Waldron Journal: Cancer Date: 2020-06-01 Impact factor: 6.860
Authors: David J Thomson; David Palma; Matthias Guckenberger; Panagiotis Balermpas; Jonathan J Beitler; Pierre Blanchard; David Brizel; Wilfred Budach; Jimmy Caudell; June Corry; Renzo Corvo; Mererid Evans; Adam S Garden; Jordi Giralt; Vincent Gregoire; Paul M Harari; Kevin Harrington; Ying J Hitchcock; Jorgen Johansen; Johannes Kaanders; Shlomo Koyfman; J A Langendijk; Quynh-Thu Le; Nancy Lee; Danielle Margalit; Michelle Mierzwa; Sandro Porceddu; Yoke Lim Soong; Ying Sun; Juliette Thariat; John Waldron; Sue S Yom Journal: Radiother Oncol Date: 2020-07-27 Impact factor: 6.280
Authors: David J Thomson; David Palma; Matthias Guckenberger; Panagiotis Balermpas; Jonathan J Beitler; Pierre Blanchard; David Brizel; Wilfred Budach; Jimmy Caudell; June Corry; Renzo Corvo; Mererid Evans; Adam S Garden; Jordi Giralt; Vincent Gregoire; Paul M Harari; Kevin Harrington; Ying J Hitchcock; Jorgen Johansen; Johannes Kaanders; Shlomo Koyfman; J A Langendijk; Quynh-Thu Le; Nancy Lee; Danielle Margalit; Michelle Mierzwa; Sandro Porceddu; Yoke Lim Soong; Ying Sun; Juliette Thariat; John Waldron; Sue S Yom Journal: Int J Radiat Oncol Biol Phys Date: 2020-04-14 Impact factor: 7.038