Prognostic potential of mid-treatment nodal response in oropharyngeal squamous cell carcinoma.
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ABSTRACT: Background
We examine the prognostic implications of mid-course nodal response in oropharyngeal cancer (OPX) to radiation therapy.Methods
In 44 patients with node-positive OPX undergoing concurrent chemoradiation, nodal volumes were measured on cone beam CTs from days 1, 10, 20, and 35. Nodal decrease (ND) was based on percent shrinkage from day 1.Results
At a median follow-up of 17 months, the 2-year disease-free survival (DFS), locoregional control (LRC), distant metastasis-free survival (DMFS), and overall survival (OS) were 87%, 92%, 89%, and 92%, respectively. Patients with ND ≥43% at D20 had improved LRC (100% vs 78.4%, P = .03) compared to D20 ND <43%. On multivariate analysis, D20 ≥43% was independently prognostic for LRC (HR 1.17, P = .05).Conclusion
Patients with low-risk oropharynx cancer with ND of ≥43% by treatment day 20 had significantly improved LRC. The prognostic benefit of ND may assist in identifying candidates for treatment de-escalation.
SUBMITTER: Byun DJ
PROVIDER: S-EPMC9879731 | biostudies-literature | 2020 Sep
REPOSITORIES: biostudies-literature
Publications
Prognostic potential of mid-treatment nodal response in oropharyngeal squamous cell carcinoma.
Byun David J DJ Tam Moses M MM Jacobson Adam S AS Persky Mark S MS Tran Theresa T TT Givi Babak B DeLacure Mark D MD Li Zujun Z Harrison Louis B LB Hu Kenneth S KS
Head & neck 20200921
<h4>Background</h4>We examine the prognostic implications of mid-course nodal response in oropharyngeal cancer (OPX) to radiation therapy.<h4>Methods</h4>In 44 patients with node-positive OPX undergoing concurrent chemoradiation, nodal volumes were measured on cone beam CTs from days 1, 10, 20, and 35. Nodal decrease (ND) was based on percent shrinkage from day 1.<h4>Results</h4>At a median follow-up of 17 months, the 2-year disease-free survival (DFS), locoregional control (LRC), distant metast ...[more]
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2021-04-13 | GSE171898 | GEO
Project description:Purpose of reviewTo discuss the changing landscape and significant developments in the diagnosis and management of oropharyngeal squamous cell carcinoma.Recent findingsHigh-risk human papilloma viruses (HPVs) have been recognized as important causative factors for oropharyngeal cancer. The diagnosis is established with type-specific and broad-spectrum in-situ hybridization probes and/or p16 immunohistochemistry assays on fresh frozen paraffin-embedded tissue blocks. HPV-associated tumors have superior response and outcomes compared with HPV-unrelated tumors. Retrospective studies have been able to stratify oropharyngeal squamous cell carcinoma based on HPV status, tumor stage, nodal stage, and smoking history into risk groups with differing risks of death or distant disease. Selected patients, nonsmokers with less advanced nodal stage, may be overtreated with current treatment paradigms, and deintensification of curative therapy is a current research focus for these patients. Smokers, patients with advanced nodal or tumor stage, and those with HPV-unrelated cancers have a less favorable prognosis and the search for novel targets is particularly important for these patients.SummaryThe present review will highlight the current standards and the future direction of novel therapies in both HPV-associated and HPV-unrelated cancers.
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