Back to Search
Start Over
Long-term recurrence-free survival after an unplanned reduction in radiotherapy for HPV-positive oropharyngeal SCC: Two cases and a review of the literature.
- Source :
-
Ear, nose, & throat journal [Ear Nose Throat J] 2017 Jul; Vol. 96 (7), pp. E23-E27. - Publication Year :
- 2017
-
Abstract
- There is currently no clear distinction between the treatment of HPV-positive and HPV-negative oropharyngeal squamous cell carcinoma (OPSCC). HPV-positive OPSCC has been demonstrated to be more radiosensitive than its HPV-negative counterpart. Despite this, patients with HPV-positive OPSCC continue to receive a full dose of radiation (70 Gy) outside clinical trials. However, this high dose comes with considerable morbidities, including severe mucositis, dysphagia, and xerostomia. We describe the cases of 2 patients with HPV-positive OPSCC who received two cycles of high-dose cisplatin at 100 mg/m <superscript>2</superscript> on 3 separate days, along with concurrent radiotherapy at 50 Gy in 25 fractions for one and 46 Gy in 23 fractions for the other. During treatment, both patients experienced significant acute-phase toxicities-including grade 3 mucositis, grade 3 nausea, and grade 2 dermatitis-and their treatment regimen was stopped before its planned completion. Nevertheless, after a follow-up of 75 and 78 months, respectively, neither patient exhibited any evidence of disease. Late toxicities included grade 1 xerostomia, grade 1 pharyngeal-phase dysphagia, and grade 1 dysgeusia with some foods. We conclude that de-escalating the dose of radiation for HPV-positive patients by 30% and identifying which patients can safely be treated with this level of dose reduction warrants further study.
- Subjects :
- Antineoplastic Agents adverse effects
Carcinoma, Squamous Cell virology
Chemoradiotherapy adverse effects
Cisplatin adverse effects
Disease-Free Survival
Dose-Response Relationship, Radiation
Humans
Male
Middle Aged
Oropharyngeal Neoplasms virology
Treatment Outcome
Withholding Treatment
Antineoplastic Agents administration & dosage
Carcinoma, Squamous Cell therapy
Chemoradiotherapy methods
Cisplatin administration & dosage
Oropharyngeal Neoplasms therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1942-7522
- Volume :
- 96
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Ear, nose, & throat journal
- Publication Type :
- Academic Journal
- Accession number :
- 28719715
- Full Text :
- https://doi.org/10.1177/014556131709600705