Premium
Outcomes of patients with oropharyngeal squamous cell carcinoma treated with induction chemotherapy followed by concurrent chemoradiation compared with those treated with concurrent chemoradiation
Author(s) -
Guo Theresa W.,
Saiyed Faiez,
Yao Christopher M. K. L.,
Kiong Kimberley L.,
Martinez Julian,
Sacks Ruth,
Lee J. Jack,
Moreno Amy C.,
Frank Steven J.,
Rosenthal David I.,
Glisson Bonnie S.,
Ferrarotto Renata,
Mott Frank E.,
Johnson Faye M.,
Myers Jeffrey N.
Publication year - 2021
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.33491
Subject(s) - medicine , cetuximab , oncology , hazard ratio , chemotherapy , induction chemotherapy , stage (stratigraphy) , head and neck cancer , radiation therapy , head and neck squamous cell carcinoma , metastasis , cancer , confidence interval , colorectal cancer , paleontology , biology
Background Induction chemotherapy (IC) has been associated with a decreased risk of distant metastasis in locally advanced head and neck squamous cell carcinoma. However, its role in the treatment of oropharyngeal squamous cell carcinoma (OPSCC) is not well established. Methods The outcomes of patients with OPSCC treated with IC followed by concurrent chemoradiation (CRT) were compared with the outcomes of those treated with CRT alone. The primary outcome was overall survival (OS), and the secondary end points were the times to locoregional and distant recurrence. Results In an existing database, 585 patients met the inclusion criteria: 137 received IC plus CRT, and 448 received CRT. Most patients were positive for human papillomavirus (HPV; 90.9%). Patients receiving IC were more likely to present with a higher T stage, a higher N stage, and low neck disease. The 3‐year OS rate was significantly lower in patients receiving IC (75.7%) versus CRT alone (92.9%). In a multicovariate analysis, receipt of IC (adjusted hazard ratio [aHR], 3.4; P < .001), HPV tumor status (aHR, 0.36; P = .002), and receipt of concurrent cetuximab (aHR, 2.7; P = .002) were independently associated with OS. The risk of distant metastasis was also significantly higher in IC patients (aHR, 2.8; P = .001), whereas an HPV‐positive tumor status (aHR, 0.44; P = .032) and completion of therapy (aHR, 0.51; P = .034) were associated with a lower risk of distant metastasis. In HPV‐positive patients, IC remained associated with distant metastatic progression (aHR, 2.6; P = .004) but not OS. Conclusions In contrast to prior studies, IC was independently associated with worse OS and a higher risk of distant metastasis in patients with OPSCC. Future studies are needed to validate these findings.