Mature results from a Swedish comparison study of conventional versus accelerated radiotherapy in head and neck squamous cell carcinoma – The ARTSCAN trial. Issue 1 (October 2015)

• Record Type: Journal Article
• Authors: Zackrisson, Björn; Kjellén, Elisabeth; Söderström, Karin; Brun, Eva; Nyman, Jan; Friesland, Signe; Reizenstein, Johan; Sjödin, Helena; Ekberg, Lars; Lödén, Britta; Franzén, Lars; Ask, Anders; Wickart-Johansson, Gun; Lewin, Freddi; Björk-Eriksson, Thomas; Lundin, Erik; Dalianis, Tina; Wennerberg, Johan; Johansson, Karl-Axel; Nilsson, Per
• Is Part Of: Radiotherapy and oncology. Volume 117:Issue 1(2015:Oct.)
• Page Start: 99
• Page End: 105
• Publication Date: 2015-10
• Subjects: Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2015.09.024
• Languages: English
• ISSNs: 0167-8140

Abstract

<abstract xml:lang="en" abstract-type="author" id="ab005"> <title id="st005">Abstract</title> <sec> <title id="st010">Background and purpose</title> <p id="sp0005">This report contains the mature five-year data from the Swedish ARTSCAN trial including information on the influence of p16 positivity (p16+) for oropharyngeal cancers.</p> </sec> <sec> <title id="st015">Material and methods</title> <p id="sp0010">Patients with previously untreated squamous cell carcinoma without distant metastases of the oral cavity, oropharynx, larynx (except T1–2, N0 glottic cancers) and hypopharynx were included. Patients were randomised between accelerated fractionation (AF) (1.1 Gy + 2 Gy per day, 5 days/week for 4.5 weeks, total dose 68 Gy) and conventional fractionation (CF) (2 Gy per day, 5 days/week for 7 weeks, total dose 68 Gy). Human papillomavirus (HPV)-associated p16-expression was assessed retrospectively in tumour tissues from patients with oropharyngeal carcinoma.</p> </sec> <sec> <title id="st020">Results</title> <p id="sp0015">There was no significant difference in loco-regional control (LRC) between AF and CF (log-rank test <italic>p</italic> = 0.75). LRC at 5 years was 65.5% for AF and 64.9% for CF. Overall survival (OS) was similar in both arms (<italic>p</italic> = 0.99). The estimated cancer specific survival (CSS) at 5 years was 62.2% (AF) and 63.3% (CF) (<italic>p</italic> = 0.99). 206 specimens were analysed for p16 with 153 specimens (74%) identified as p16+. P16 status did not discriminate for response to AF vs. CF with regard to LRC, OS or CSS. Patients with p16+ tumours had a statistically significant better overall prognosis compared with p16− tumours.</p> </sec> <sec> <title id="st025">Conclusion</title> <p id="sp0020">This update confirms the results of the 2-year report. We failed to identify a positive effect resulting from AF with regards to LRC, OS and CSS. The addition of information on the HPV-associated p16 overexpression did not explain this lack of effect.</p> </sec> </abstract>