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Outcomes of HPV-related oropharyngeal cancer patients treated by radiotherapy alone using altered fractionation

2012; Elsevier BV; Volume: 103; Issue: 1 Linguagem: Inglês

10.1016/j.radonc.2012.02.009

1879-0887

Brian O’Sullivan, Shao Hui Huang, Bayardo Perez-Ordóñez, Christine Massey, Lillian L. Siu, Ilan Weinreb, Andrew Hope, John Kim, Andrew Bayley, Bernard Cummings, Jolie Ringash, Laura A. Dawson, B.C. John Cho, Eric X. Chen, Jonathan C. Irish, Ralph Gilbert, Angela Bik‐Yu Hui, Fei‐Fei Liu, Helen Zhao, John Waldron, Wei Xu,

Lung Cancer Research Studies

To report outcome of HPV-related [HPV(+)] oropharyngeal cancer (OPC) managed predominantly by altered-fractionation radiotherapy-alone (RT-alone).OPCs treated with RT-alone (n = 207) or chemoradiotherapy (CRT) (n = 151) from 2001 to 2008 were included. Overall survival (OS), local (LC), regional (RC) and distant (DC) control were compared for HPV(+) vs. HPV-unrelated [HPV(-)], by RT-alone vs. CRT, and by smoking pack-years (≤ 10 vs. >10). Multivariate analysis identified predictors.HPV(+) (n = 277) had better OS (81% vs. 44%), LC (93% vs. 76%), RC (94% vs. 79%) (all p < 0.01) but similar DC (89% vs. 86%, p = 0.87) vs. HPV(-) (n = 81). HPV(+) stage IV CRT (n = 125) had better OS (89% vs. 70%, p < 0.01), but similar LC (93% vs. 90%, p = 0.41), RC (94% vs. 90%, p = 0.31) and DC (90% vs. 83%, p = 0.22) vs. RT-alone (n = 96). Both HPV(+) RT-alone (n = 37) and CRT (n = 67) stage IV minimal smokers had favorable OS (86% vs. 88%, p = 0.45), LC (95% vs. 92%, p = 0.52), RC (97% vs. 93%, p = 0.22), and DC (92% vs. 86%, p = 0.37). RT-alone and heavy-smoking were independent predictors for lower OS but not CSS in multivariate analysis.Overall, HPV(+) RT-alone stage IV demonstrated lower survival but comparable disease control vs. CRT, but no difference was apparent among minimal smokers.