Neoadjuvant chemotherapy followed by surgery for HPV‐associated locoregionally advanced oropharynx cancer. Issue 8 (25th March 2020)

• Record Type: Journal Article
• Authors: Sadeghi, Nader; Mascarella, Marco A.; Khalife, Sarah; Ramanakumar, Agnihotram V.; Richardson, Keith; Joshi, Arjun S.; Taheri, Reza; Fuson, Andrew; Bouganim, Nathaniel; Siegel, Robert
• Is Part Of: Head & neck. Volume 42:Issue 8(2020)
• Page Start: 2145
• Page End: 2154
• Publication Date: 2020-03-25
• Subjects: Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.26147
• Languages: English
• ISSNs: 1043-3074

Abstract

Abstract: Background: Neoadjuvant chemotherapy followed by surgery (NAC + S), a paradigm based on systemic escalation coupled with surgery‐based de‐escalation, is under investigation for treatment of HPV‐associated oropharynx cancer (OPC). Methods: Prospective cohort of patients with non‐metastatic, p16 positive OPC enrolled in a clinical trial of NAC + S was compared to a historic cohort of patients undergoing concurrent chemoradiation (CCRT) to compare disease‐free survival (DFS). Results: Fifty‐five patients were treated with NAC + S and 142 with CCRT. Stage‐matched patients undergoing CCRT had higher frequency of smoking and alcohol consumption. 5‐year DFS in the NAC + S group was 96.1% (95% CI 90.8‐100) compared to 67.6% (95% CI 50.7‐84.5) for CCRT ( P = .01). At 12 months from treatment, 24.5% of patients undergoing CCRT and none of the patients in the NAC + S were feeding tube dependent ( P < .0001). Conclusion: NAC + S may be a novel approach for HPV‐associated OPC as it provides lower feeding tube dependence and improved survival compared to stage‐matched patients undergoing CCRT.