Feasibility of Dose-escalated Hypofractionated Chemoradiation in Human Papilloma Virus-negative or Smoking-associated Oropharyngeal Cancer

S. Meade; P. Gaunt; A. Hartley; M. Robinson; J. Cashmore; L. Wagstaff; J. Babrah; S. J. Bowden; H. Mehanna; P. Sanghera

doi:10.1016/j.clon.2018.01.015

Feasibility of Dose-escalated Hypofractionated Chemoradiation in Human Papilloma Virus-negative or Smoking-associated Oropharyngeal Cancer

S. Meade, P. Gaunt, A. Hartley, M. Robinson, J. Cashmore, L. Wagstaff, J. Babrah, S. J. Bowden, H. Mehanna, P. Sanghera

Research output: Contribution to journal › Article › peer-review

6 Citations (Scopus)

Abstract

AIMS: Oropharyngeal squamous cell carcinoma (OPSCC) can be divided into favourable and poor prognostic groups by association with human papilloma virus (HPV) and smoking. This study prospectively investigated a dose-intensified schedule in poor/intermediate prognosis OPSCC.

MATERIALS AND METHODS: Patients with p16/HPV-negative or p16-positive N2b OPSCC with a greater than 10 pack-year smoking history were eligible. Patients were planned to receive 64 Gy in 25 fractions with cisplatin. The primary end point was absence of grade 3 mucositis at 3 months.

RESULTS: Fifteen patients were recruited over 14 months. All patients completed a minimum of 2 years of follow-up. All patients completed full-dose radiotherapy within a median treatment time of 32 days (31-35). Grade 3 mucositis was absent in all patients at 3 months. There was one grade 4 toxicity event due to cisplatin (hypokalaemia). Complete response rates at 3 months were 100% and 93% for local disease and lymph nodes, respectively. One patient developed metastatic disease and subsequently died. Overall survival at 2 years was 93% (95% confidence interval 61-99%).

CONCLUSIONS: The schedule of 64 Gy in 25 fractions with concomitant chemotherapy is tolerable in patients with poor and intermediate prognosis OPSCC.

Original language	English
Journal	Clinical Oncology
Early online date	2 Mar 2018
DOIs	https://doi.org/10.1016/j.clon.2018.01.015
Publication status	Published - Jun 2018

Keywords

Journal Article
accelerated hypofractionation
human papilloma virus
oropharyngeal cancer
smoking

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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https://www.sciencedirect.com/science/article/pii/S0936655518300463Licence: None: All rights reserved

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@article{070f3aaf077c41efa94577e103230d2a,

title = "Feasibility of Dose-escalated Hypofractionated Chemoradiation in Human Papilloma Virus-negative or Smoking-associated Oropharyngeal Cancer",

abstract = "AIMS: Oropharyngeal squamous cell carcinoma (OPSCC) can be divided into favourable and poor prognostic groups by association with human papilloma virus (HPV) and smoking. This study prospectively investigated a dose-intensified schedule in poor/intermediate prognosis OPSCC.MATERIALS AND METHODS: Patients with p16/HPV-negative or p16-positive N2b OPSCC with a greater than 10 pack-year smoking history were eligible. Patients were planned to receive 64 Gy in 25 fractions with cisplatin. The primary end point was absence of grade 3 mucositis at 3 months.RESULTS: Fifteen patients were recruited over 14 months. All patients completed a minimum of 2 years of follow-up. All patients completed full-dose radiotherapy within a median treatment time of 32 days (31-35). Grade 3 mucositis was absent in all patients at 3 months. There was one grade 4 toxicity event due to cisplatin (hypokalaemia). Complete response rates at 3 months were 100% and 93% for local disease and lymph nodes, respectively. One patient developed metastatic disease and subsequently died. Overall survival at 2 years was 93% (95% confidence interval 61-99%).CONCLUSIONS: The schedule of 64 Gy in 25 fractions with concomitant chemotherapy is tolerable in patients with poor and intermediate prognosis OPSCC.",

keywords = "Journal Article, accelerated hypofractionation , human papilloma virus , oropharyngeal cancer , smoking",

author = "S. Meade and P. Gaunt and A. Hartley and M. Robinson and J. Cashmore and L. Wagstaff and J. Babrah and Bowden, {S. J.} and H. Mehanna and P. Sanghera",

note = "Copyright {\textcopyright} 2018. Published by Elsevier Ltd.",

year = "2018",

month = jun,

doi = "10.1016/j.clon.2018.01.015",

language = "English",

journal = "Clinical Oncology",

issn = "0936-6555",

publisher = "Elsevier",

}

TY - JOUR

T1 - Feasibility of Dose-escalated Hypofractionated Chemoradiation in Human Papilloma Virus-negative or Smoking-associated Oropharyngeal Cancer

AU - Meade, S.

AU - Gaunt, P.

AU - Hartley, A.

AU - Robinson, M.

AU - Cashmore, J.

AU - Wagstaff, L.

AU - Babrah, J.

AU - Bowden, S. J.

AU - Mehanna, H.

AU - Sanghera, P.

PY - 2018/6

Y1 - 2018/6

N2 - AIMS: Oropharyngeal squamous cell carcinoma (OPSCC) can be divided into favourable and poor prognostic groups by association with human papilloma virus (HPV) and smoking. This study prospectively investigated a dose-intensified schedule in poor/intermediate prognosis OPSCC.MATERIALS AND METHODS: Patients with p16/HPV-negative or p16-positive N2b OPSCC with a greater than 10 pack-year smoking history were eligible. Patients were planned to receive 64 Gy in 25 fractions with cisplatin. The primary end point was absence of grade 3 mucositis at 3 months.RESULTS: Fifteen patients were recruited over 14 months. All patients completed a minimum of 2 years of follow-up. All patients completed full-dose radiotherapy within a median treatment time of 32 days (31-35). Grade 3 mucositis was absent in all patients at 3 months. There was one grade 4 toxicity event due to cisplatin (hypokalaemia). Complete response rates at 3 months were 100% and 93% for local disease and lymph nodes, respectively. One patient developed metastatic disease and subsequently died. Overall survival at 2 years was 93% (95% confidence interval 61-99%).CONCLUSIONS: The schedule of 64 Gy in 25 fractions with concomitant chemotherapy is tolerable in patients with poor and intermediate prognosis OPSCC.

AB - AIMS: Oropharyngeal squamous cell carcinoma (OPSCC) can be divided into favourable and poor prognostic groups by association with human papilloma virus (HPV) and smoking. This study prospectively investigated a dose-intensified schedule in poor/intermediate prognosis OPSCC.MATERIALS AND METHODS: Patients with p16/HPV-negative or p16-positive N2b OPSCC with a greater than 10 pack-year smoking history were eligible. Patients were planned to receive 64 Gy in 25 fractions with cisplatin. The primary end point was absence of grade 3 mucositis at 3 months.RESULTS: Fifteen patients were recruited over 14 months. All patients completed a minimum of 2 years of follow-up. All patients completed full-dose radiotherapy within a median treatment time of 32 days (31-35). Grade 3 mucositis was absent in all patients at 3 months. There was one grade 4 toxicity event due to cisplatin (hypokalaemia). Complete response rates at 3 months were 100% and 93% for local disease and lymph nodes, respectively. One patient developed metastatic disease and subsequently died. Overall survival at 2 years was 93% (95% confidence interval 61-99%).CONCLUSIONS: The schedule of 64 Gy in 25 fractions with concomitant chemotherapy is tolerable in patients with poor and intermediate prognosis OPSCC.

KW - Journal Article

KW - accelerated hypofractionation

KW - human papilloma virus

KW - oropharyngeal cancer

KW - smoking

U2 - 10.1016/j.clon.2018.01.015

DO - 10.1016/j.clon.2018.01.015

M3 - Article

C2 - 29478732

SN - 0936-6555

JO - Clinical Oncology

JF - Clinical Oncology

ER -

Feasibility of Dose-escalated Hypofractionated Chemoradiation in Human Papilloma Virus-negative or Smoking-associated Oropharyngeal Cancer

Abstract

Keywords

UN SDGs

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