Reducing Treatment of HPV+ Oropharyngeal Cancer May Compromise Safety

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Triple-modality therapy was associated with improved survival among patients with stage 3 disease.
Triple-modality therapy was associated with improved survival among patients with stage 3 disease.

HealthDay News — For patients with human papillomavirus (HPV)+ stage 1 or 2 oropharyngeal cancer, deintensification of treatment from chemoradiotherapy to one modality may compromise safety, according to a study published in Cancer.

Shayan Cheraghlou, from the Yale School of Medicine in New Haven, Connecticut, and colleagues conducted a retrospective study involving 4443 patients with HPV+ oropharyngeal cancer. Patients were stratified according to disease stage groups of the American Joint Committee on Cancer (AJCC) eighth edition.

The researchers found that treatment with definitive radiotherapy was correlated with decreased survival vs chemotherapy, surgery with adjuvant radiotherapy, or surgery with adjuvant chemoradiotherapy (hazard ratios, 1.798, 2.563, and 2.427, respectively) among patients with stage 1 disease. 

Compared with treatment with chemoradiotherapy, patients with stage 2 disease treated with a single modality had poorer survival (hazard ratio for surgery or radiotherapy, 2.539 and 2.2, respectively). Compared with chemoradiotherapy, triple-modality therapy was associated with improved survival among patients with stage 3 disease (hazard ratio, 0.518).

"Deintensification of treatment from chemoradiotherapy to radiotherapy or surgery alone in cases of HPV+ AJCC eighth edition stage 1 or stage 2 disease may compromise patient safety," the authors write. "Treatment intensification to triple-modality therapy for patients with stage 3 disease may improve survival in this group."

Two authors disclosed financial ties to the pharmaceutical and medical device industries. The study was partially funded by DePuy Synthes.

Reference

Cheraghlou S, Yu PK, Otremba MD, et al. Treatment deintensification in human papillomavirus-positive oropharynx cancer: Outcomes from the National Cancer Data Base [published online December 15, 2017]. Cancer. doi: 10.1002/cncr.31104

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