Cargando…

Adjuvant Radiation Therapy Alone for HPV Related Oropharyngeal Cancers with High Risk Features

BACKGROUND: Current standard of care for oropharyngeal cancers with positive surgical margins and/or extracapsular extension is adjuvant chemoradiotherapy. It is unknown whether HPV+ oropharyngeal cancer benefits from this treatment intensification. OBJECTIVE: To investigate the outcomes of HPV+ pat...

Descripción completa

Detalles Bibliográficos
Autores principales: Su, William, Liu, Jerry, Miles, Brett A., Genden, Eric M., Misiukiewicz, Krzysztof J., Posner, Marshall, Gupta, Vishal, Bakst, Richard L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5145232/
https://www.ncbi.nlm.nih.gov/pubmed/27930732
http://dx.doi.org/10.1371/journal.pone.0168061
Descripción
Sumario:BACKGROUND: Current standard of care for oropharyngeal cancers with positive surgical margins and/or extracapsular extension is adjuvant chemoradiotherapy. It is unknown whether HPV+ oropharyngeal cancer benefits from this treatment intensification. OBJECTIVE: To investigate the outcomes of HPV+ patients treated with adjuvant radiotherapy alone when chemoradiotherapy was indicated based on high risk pathological features. They were compared with high risk HPV+ patients treated with adjuvant chemoradiotherapy. METHODS: All high risk HPV+ oropharyngeal cancer patients (9) who received radiotherapy alone were identified. We also identified 17 patients who received chemoradiotherapy as a comparison group. Median follow up time was 37.3 months. RESULTS: No local failures developed in adjuvant radiotherapy group. There was 1 distant recurrence in this cohort and 3 in CRT cohort. Regarding toxicity, 8 (47.1%) chemoradiotherapy patients had >10 lb. weight loss (p = 0.013), despite 75% of them having a percutaneous endoscopic gastrostomy tube placed. No individuals in radiotherapy group experienced a >10 lb. weight loss and none required a gastrostomy tube. CONCLUSIONS: This series provides preliminary evidence suggesting that the omission of concurrent chemotherapy to adjuvant radiotherapy may offer comparative local control rates with a lower toxicity profile in the setting of HPV+ patients with traditional high risk features.