Patterns of care and survival impact of adjuvant chemoradiotherapy for oropharyngeal cancer with intermediate‐risk features. Issue 9 (20th May 2019)

• Record Type: Journal Article
• Authors: Goel, Alexander N.; Sangar, Sophia; Mukdad, Laith; Heaton, Chase M.; Ryan, William R.; Wang, Marilene B.; Long, Jennifer L.; St. John, Maie A.
• Is Part Of: Head & neck. Volume 41:Issue 9(2019)
• Page Start: 3177
• Page End: 3186
• Publication Date: 2019-05-20
• Subjects: adjuvant chemoradiotherapy -- human papillomavirus -- National Cancer Database -- oropharyngeal cancer -- squamous cell carcinoma; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.25808
• Languages: English
• ISSNs: 1043-3074

Abstract

Abstract: Background: Survival outcomes for adjuvant chemoradiotherapy (aCRT) and adjuvant radiotherapy (aRT) were compared in patients with oropharyngeal squamous cell carcinoma (OPSCC) with intermediate‐risk features. Methods: We identified 2164 patients with OPSCC in the National Cancer Database without positive margins or extracapsular extension and with at least one intermediate‐risk feature: pT3‐T4 disease, ≥two positive lymph nodes, level IV/V nodal disease, and/or lymphovascular invasion. We assessed predictors of aCRT use and covariables impacting overall survival. Results: aCRT was commonly used for both human papillomavirus (HPV)‐positive (62.0%) and HPV‐negative (64.3%) patients with OPSCC. Higher N stage, level IV/V neck disease, and younger age strongly predicted aCRT utilization. There was no significant survival benefit associated with aCRT vs aRT in HPV‐positive (hazard ratio [HR], 0.93; 95% confidence interval [CI], 0.62‐1.38; P = .71) or HPV‐negative (HR, 0.75; 95% CI, 0.51‐1.10; P = .15) disease. Conclusions: Despite high rates of utilization, aCRT is not associated with better survival vs aRT for OPSCC with intermediate‐risk features, including HPV‐negative tumors.