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
_version_ 1782473261619085312
author Su, William
Liu, Jerry
Miles, Brett A.
Genden, Eric M.
Misiukiewicz, Krzysztof J.
Posner, Marshall
Gupta, Vishal
Bakst, Richard L.
author_facet Su, William
Liu, Jerry
Miles, Brett A.
Genden, Eric M.
Misiukiewicz, Krzysztof J.
Posner, Marshall
Gupta, Vishal
Bakst, Richard L.
author_sort Su, William
collection PubMed
description 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.
format Online
Article
Text
id pubmed-5145232
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-51452322016-12-22 Adjuvant Radiation Therapy Alone for HPV Related Oropharyngeal Cancers with High Risk Features Su, William Liu, Jerry Miles, Brett A. Genden, Eric M. Misiukiewicz, Krzysztof J. Posner, Marshall Gupta, Vishal Bakst, Richard L. PLoS One Research Article 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. Public Library of Science 2016-12-08 /pmc/articles/PMC5145232/ /pubmed/27930732 http://dx.doi.org/10.1371/journal.pone.0168061 Text en © 2016 Su et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Su, William
Liu, Jerry
Miles, Brett A.
Genden, Eric M.
Misiukiewicz, Krzysztof J.
Posner, Marshall
Gupta, Vishal
Bakst, Richard L.
Adjuvant Radiation Therapy Alone for HPV Related Oropharyngeal Cancers with High Risk Features
title Adjuvant Radiation Therapy Alone for HPV Related Oropharyngeal Cancers with High Risk Features
title_full Adjuvant Radiation Therapy Alone for HPV Related Oropharyngeal Cancers with High Risk Features
title_fullStr Adjuvant Radiation Therapy Alone for HPV Related Oropharyngeal Cancers with High Risk Features
title_full_unstemmed Adjuvant Radiation Therapy Alone for HPV Related Oropharyngeal Cancers with High Risk Features
title_short Adjuvant Radiation Therapy Alone for HPV Related Oropharyngeal Cancers with High Risk Features
title_sort adjuvant radiation therapy alone for hpv related oropharyngeal cancers with high risk features
topic Research Article
url 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
work_keys_str_mv AT suwilliam adjuvantradiationtherapyaloneforhpvrelatedoropharyngealcancerswithhighriskfeatures
AT liujerry adjuvantradiationtherapyaloneforhpvrelatedoropharyngealcancerswithhighriskfeatures
AT milesbretta adjuvantradiationtherapyaloneforhpvrelatedoropharyngealcancerswithhighriskfeatures
AT gendenericm adjuvantradiationtherapyaloneforhpvrelatedoropharyngealcancerswithhighriskfeatures
AT misiukiewiczkrzysztofj adjuvantradiationtherapyaloneforhpvrelatedoropharyngealcancerswithhighriskfeatures
AT posnermarshall adjuvantradiationtherapyaloneforhpvrelatedoropharyngealcancerswithhighriskfeatures
AT guptavishal adjuvantradiationtherapyaloneforhpvrelatedoropharyngealcancerswithhighriskfeatures
AT bakstrichardl adjuvantradiationtherapyaloneforhpvrelatedoropharyngealcancerswithhighriskfeatures