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Radiotherapy dose and survival outcomes in human papillomavirus positive oropharyngeal cancer

Published online by Cambridge University Press:  18 June 2020

M Tam ,
S P Wu ,
N K Gerber ,
A Lee ,
D Schreiber ,
B Givi  and
K Hu
M Tam*
Affiliation:
Department of Radiation Oncology, New York University School of Medicine, USA
S P Wu
Affiliation:
Department of Radiation Oncology, New York University School of Medicine, USA
N K Gerber
Affiliation:
Department of Radiation Oncology, New York University School of Medicine, USA
A Lee
Affiliation:
Department of Radiation Oncology, State University of New York (‘SUNY’) Downstate Medical Center, New York, USA
D Schreiber
Affiliation:
Veterans Affairs New York Harbor Healthcare System, Brooklyn, New York, USA
B Givi
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, New York University School of Medicine, USA
K Hu
Affiliation:
Department of Radiation Oncology, New York University School of Medicine, USA
*
Author for correspondence: Dr Moses Tam, 160 E. 34th Street, New York, NY 10016, USA E-mail: moses.tam@nyumc.org Fax: +1 212 731 5512
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Abstract

Objective

To evaluate the effect of definitive radiotherapy dose on survival in patients with human papillomavirus positive oropharyngeal carcinoma.

Methods

Human papillomavirus positive oropharyngeal carcinoma patients staged T1–3 and N0–2c, who received definitive radiotherapy (fraction sizes of 180 cGy to less than 220 cGy), were identified from the National Cancer Database 2010–2014 and stratified by radiation dose (50 Gy to less than 66 Gy, or 66 Gy or more).

Results

A total of 2173 patients were included, of whom 124 (6 per cent) received a radiation dose of 50 Gy to less than 66 Gy. With a median follow up of 33.8 months, patients had a 3-year overall survival rate of 88.6 per cent (95 per cent confidence interval = 87.1–90.1 per cent). On multivariate Cox analysis, a radiotherapy dose of 50 Gy to less than 66 Gy (hazard ratio = 0.95, 95 per cent confidence interval = 0.52–1.74, p = 0.86) was not a predictor of increased mortality risk.

Conclusion

Human papillomavirus positive oropharyngeal carcinoma patients had excellent outcomes with definitive radiotherapy doses of 50 Gy to less than 66 Gy. These results further support patients enrolling into clinical trials for radiation dose de-escalation.

Keywords

HPV, Human Papillomavirus VirusesOropharyngeal CancerNCDBNational Cancer DatabaseRadiotherapyDe-Escalation
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 134 , Issue 6 , June 2020 , pp. 533 - 540
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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Footnotes

Dr M Tam takes responsibility for the integrity of the content of the paper

Portions of this work were presented in abstract and poster form at the 59th Annual Meeting of the American Society for Radiation Oncology, 24–27 September 2017, San Diego, California, USA.

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