Low-risk OPSCC: CRT no better than RT for reducing odds of DM in Canadian study

  • Hall SF & al.
  • Head Neck
  • 4 févr. 2019

  • Par Brian Richardson, PhD
  • Résumés d'articles
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Takeaway

  • A retrospective, population-based study suggests that chemoradiotherapy (CRT) is associated with similar rates of distant metastasis as RT alone in most patients with HPV-positive/negative oropharyngeal squamous cell carcinoma (OPSCC).

Why this matters

  • Distant metastasis is the leading cause of death in patients with OPSCC.

Key results

  • 11.4% of patients developed distant metastases.
  • T3 status (HR, 2.898; P=.0216), N2 status (HR, 2.651; P=.0112), and N3 status (HR, 7.949; P=.0034) were associated with risk for distant metastasis.
  • HPV-positive status was inversely associated (HR, 0.357; P=.0007) with risk for distant metastasis.
  • RT and CRT were associated with similar risk for distant metastasis (HR, 1.152; P=.6363).
    • HR, 0.894 (P=.7697) in HPV-positive patients
  • CRT did not reduce the risk for distant metastasis in HPV-negative patients (HR 1.82, 95% CI 0.65-5.07).
  • In HPV-positive patients, T4 status (HR 4.121, P=.280) and high-risk status (HR 2.800, P=.0106) were associated with risk for distant metastasis.

Study design

  • 525 patients with OPSCC were analyzed for associations among HPV status, treatment modality, and rates of distant metastasis.
  • Funding: Canadian Institutes of Health Research; Canadian Cancer Society Research Institute.

Limitations

  • Location of distant metastasis not included in analysis.
  • Retrospective study.