BACKGROUND: Aggressive dose de-escalated adjuvant radiation therapy (RT) in patients with human papillomavirus-associated oropharyngeal squamous cell carcinoma (HPV(+)OPSCC). METHODS: Patients with HPV(+)OPSCC on a phase II clinical trial of primary surgery and neck dissection followed by dose de-escalated RT (N = 79) were compared with a cohort of patients who received standard adjuvant therapy (N = 115). Local recurrence-free, regional recurrence-free, distant metastases-free survival, and progression-free survival (PFS) were assessed. RESULTS: Of 194 patients, 23 experienced progression at a median of 1.1 years following surgery (interquartile range [IQR] 0.7-2.0; range 0.3-5.4); 10 patients in the de-escalated cohort and 13 patients in the standard cohort. The 3-year PFS rate for the de-escalated cohort was 87%, and in the standard cohort was 90% (hazard ratio [HR] 1.18, 95% confidence interval (CI) [0.50-2.75]). CONCLUSION: Patients with HPV(+)OPSCC who undergo surgical resection and neck dissection and meet criteria for adjuvant therapy can undergo aggressive dose de-escalation of RT without increasing risk of progression locally, regionally or at distant sites.
BACKGROUND: Aggressive dose de-escalated adjuvant radiation therapy (RT) in patients with human papillomavirus-associated oropharyngeal squamous cell carcinoma (HPV(+)OPSCC). METHODS:Patients with HPV(+)OPSCC on a phase II clinical trial of primary surgery and neck dissection followed by dose de-escalated RT (N = 79) were compared with a cohort of patients who received standard adjuvant therapy (N = 115). Local recurrence-free, regional recurrence-free, distant metastases-free survival, and progression-free survival (PFS) were assessed. RESULTS: Of 194 patients, 23 experienced progression at a median of 1.1 years following surgery (interquartile range [IQR] 0.7-2.0; range 0.3-5.4); 10 patients in the de-escalated cohort and 13 patients in the standard cohort. The 3-year PFS rate for the de-escalated cohort was 87%, and in the standard cohort was 90% (hazard ratio [HR] 1.18, 95% confidence interval (CI) [0.50-2.75]). CONCLUSION:Patients with HPV(+)OPSCC who undergo surgical resection and neck dissection and meet criteria for adjuvant therapy can undergo aggressive dose de-escalation of RT without increasing risk of progression locally, regionally or at distant sites.
Authors: Daniel R Dickstein; Eric J Lehrer; Kristin Hsieh; Alexandra Hotca; Brianna M Jones; Ann Powers; Sonam Sharma; Jerry Liu; Vishal Gupta; Loren Mell; Zain Husain; Diana Kirke; Krzysztof Misiukiewicz; Marshall Posner; Eric Genden; Richard L Bakst Journal: Cancers (Basel) Date: 2022-06-05 Impact factor: 6.575
Authors: Roman O Kowalchuk; Kathryn M Van Abel; Adam B Sauer; Linda X Yin; Joaquin J Garcia; William S Harmsen; Eric J Moore; Daniel L Price; Ashish V Chintakuntlawar; Katharine R Price; Scott C Lester; Michelle Neben Wittich; Samir H Patel; Robert L Foote; Daniel M Ma; Alex A Nagelschneider; David M Routman Journal: Adv Radiat Oncol Date: 2022-02-23
Authors: Timon Hussain; Kruthika Thangavelu; Cornelius Kürten; Lisa Galland; Benedikt Höing; Eric Deuss; Stefan Mattheis; Stephan Lang; Cornelius Deuschl; Michael Forsting; Nils Dörner Journal: Eur Arch Otorhinolaryngol Date: 2022-07-04 Impact factor: 3.236