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Patient preferences for oropharyngeal cancer treatment de‐escalation
Author(s) -
Brotherston Drew C.,
Poon Ian,
Le Tuyen,
Leung Martin,
Kiss Alex,
Ringash Jolie,
Balogh Judith,
Lee Justin,
Wright James R.
Publication year - 2013
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.22930
Subject(s) - medicine , chemoradiotherapy , head and neck cancer , radiation therapy , oncology , chemotherapy , pathological , cancer , human papillomavirus , head and neck , surgery
Background The excellent prognosis of human papillomavirus (HPV)‐positive oropharyngeal squamous cell carcinomas (SCCs) against severe chemoradiotherapy (CRT) toxicities has opened discussion of deintensification trials. The purpose of this study was to describe the perspective of patients with HPV‐positive and HPV‐negative disease toward such studies. Methods Fifty‐one patients with oropharyngeal SCC (post‐CRT) underwent semistructured interviews contrasting toxicities of radiotherapy (RT) alone and CRT. Patients were asked what potential difference in cancer survival was acceptable to prefer RT over CRT. Initially, survival rate was the same for both treatments, then the RT rate was reduced until the preference switched. Treatment experience and preference for deintensified CRT were collected. Results Ninety‐percent of patients initially selected RT, but 69% switched to CRT after 0% to 5% reduction in survival. Patients that rated their treatment experience as mild would accept lower survival versus severe treatment ( p = .02). Eighty‐one percent of patients (33 of 40) indicated they preferred reduced chemotherapy in CRT. Conclusion Patients accept little difference in survival between treatments to avoid toxicity. © 2012 Wiley Periodicals, Inc. Head Neck, 2013