TY - JOUR
T1 - Chemoradiotherapy for locally advanced squamous cell carcinoma of the oropharynx
T2 - Does completion of systemic therapy affect outcomes?
AU - Baine, Michael
AU - Dorius, Tim
AU - Bennion, Nathan
AU - Alam, Morshed
AU - Smith, Lynette M
AU - Zhen, Weining
AU - Ganti, Apar Kishor P
N1 - Publisher Copyright:
© 2017
PY - 2017/10
Y1 - 2017/10
N2 - Introduction Current standard of care for locally advanced squamous cell carcinoma of the oropharynx (LA-OPC) consists of concurrent chemoradiotherapy. Due to toxicities associated with this treatment, a significant portion of patients are unable to complete the systemic therapy portion of their treatment course. The impact of incomplete systemic therapy on patient outcomes remains unclear. Methods Demographic, treatment, and outcome data were retrospectively collected for patients with LA-OPC treated definitively with concurrent chemoradiotherapy between 2007 and 2014. Overall and disease-free survivals were estimated via the Kaplan Meier method. Log rank test was used to compare distributions of survival amongst groups. Cox regression was utilized for all multivariate analyses. P values of <0.05 were considered statistically significant. Results In total, 73 patients with LA-OPC were identified with a median follow-up of 3.4 years. Concurrent systemic therapy regimens consisted of bolus cisplatin every 3 weeks (76.7%), weekly cetuximab (20.5%) and weekly cisplatin (2.7%). Forty-three patients (58.9%) were able to complete the prescribed concurrent systemic regimens. Upon multivariate analyses, patients who did not complete systemic therapy were noted to have a non-significant trend towards increased distant failure (20.0% vs 7.0%, p = 0.12). Additionally, patients who did not complete systemic therapy were noted to have a near significant trend towards increased risk of death (36.7% vs 17.9%, p = 0.053). Conclusions These results suggest that completing systemic therapy may affect survival in patients undergoing definitive radiotherapy with concurrent systemic therapy for LA-OPC. Further, this data demonstrates that though local recurrences are not affected when planned systemic therapy cycles are omitted, the risk of distant failure may increase. These associations require further study to clarify the effect Incomplete systemic therapy has on outcomes for LA-OPC.
AB - Introduction Current standard of care for locally advanced squamous cell carcinoma of the oropharynx (LA-OPC) consists of concurrent chemoradiotherapy. Due to toxicities associated with this treatment, a significant portion of patients are unable to complete the systemic therapy portion of their treatment course. The impact of incomplete systemic therapy on patient outcomes remains unclear. Methods Demographic, treatment, and outcome data were retrospectively collected for patients with LA-OPC treated definitively with concurrent chemoradiotherapy between 2007 and 2014. Overall and disease-free survivals were estimated via the Kaplan Meier method. Log rank test was used to compare distributions of survival amongst groups. Cox regression was utilized for all multivariate analyses. P values of <0.05 were considered statistically significant. Results In total, 73 patients with LA-OPC were identified with a median follow-up of 3.4 years. Concurrent systemic therapy regimens consisted of bolus cisplatin every 3 weeks (76.7%), weekly cetuximab (20.5%) and weekly cisplatin (2.7%). Forty-three patients (58.9%) were able to complete the prescribed concurrent systemic regimens. Upon multivariate analyses, patients who did not complete systemic therapy were noted to have a non-significant trend towards increased distant failure (20.0% vs 7.0%, p = 0.12). Additionally, patients who did not complete systemic therapy were noted to have a near significant trend towards increased risk of death (36.7% vs 17.9%, p = 0.053). Conclusions These results suggest that completing systemic therapy may affect survival in patients undergoing definitive radiotherapy with concurrent systemic therapy for LA-OPC. Further, this data demonstrates that though local recurrences are not affected when planned systemic therapy cycles are omitted, the risk of distant failure may increase. These associations require further study to clarify the effect Incomplete systemic therapy has on outcomes for LA-OPC.
KW - Chemoradiotherapy
KW - Cisplatin
KW - Head and neck cancer
KW - Locally advanced oropharyngeal cancer
KW - Radiation
KW - Squamous cell carcinoma
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U2 - 10.1016/j.oraloncology.2017.08.015
DO - 10.1016/j.oraloncology.2017.08.015
M3 - Article
C2 - 28939061
AN - SCOPUS:85028517453
SN - 1368-8375
VL - 73
SP - 105
EP - 110
JO - Oral Oncology
JF - Oral Oncology
ER -