07 Jun HPV Oropharyngeal Cancer: Reduced Dose ChemoRadiation Linked to Better 5 Year Quality of Life
MedicalResearch.com Interview with:
Mai Takahashi MD MPH
Mount Sinai Beth Israel – Resident Physician
New York, New York
MedicalResearch.com: What is the background for this study?
The incidence of head and neck cancer had been significantly increasing in North America and Europe driven by Human Papillomavirus-related cancer (HPV OPC) which account for more than 60% of total oropharyngeal cancer cases. Compared to environmentally related oropharyngeal cancer, the HPV OPC patient population is generally younger and has a much better prognosis. However, they will suffer from long-term deteriorations in quality of life (QoL) and the declines associated with treatment intensity. Hence multiple studies have focused on de-intensification therapy with reduced dose chemoradiotherapy (CRT).
MedicalResearch.com: What are the main findings?
Response: We assessed QoL in patients with locally advanced HPV OPC with poor prognostic features receiving reduced dose CRT versus standard dose CRT after induction chemotherapy. Our study demonstrated greater improvements in patient-reported QoL in the reduced CRT group at 5 years follow-up. Furthermore, patients treated with reduced dose CRT had comparable 5 year-progression free survival/overall survival to standard dose CRT arm.
MedicalResearch.com: What should readers take away from your report?
Response: Radiation is the major cause of early acute and late chronic symptomatic effects in HPV OPC patients. This study supports the notion that reduced dose CRT after induction chemotherapy may help improving long-term consequences and quality of life of patients with locally advanced HPV OPC with poor prognostic features, while maintaining survival.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Our findings point to a necessity of a larger cooperative randomized to trials to validate regimens with reduced dose radiation therapy for locally advanced HPV OPC as a standard of care.
MedicalResearch.com: Is there anything else you would like to add?
Response: Recently the importance of evaluating QoL has been increasingly recognized, however this field of research has had continued challenges. As is the nature of QoL assessment, our study also had methodological limitations including possible reporting bias and insufficient completion rates. Despite these limitations, a significant degree of impact in long-term effects of reduced dose CRT was identified.
The study was conducted with the efforts of our multi-disciplinary team from the Tisch Cancer Institute, the Icahn School of Medicine at Mount Sinai.
Abstract 6062: Quality of life analysis of HPV-positive oropharyngeal cancer patients in arandomized trial of reduced-dose (rdCRT) versus standard (sdCRT) chemoradiotherapy: 5-year follow-up
Mai Takahashi, Michael Hwang, Krzysztof Misiukiewicz, Richard Lorne Bakst, Brett A. Miles, Vishal Gupta, Marcelo Raul Bonomi, Sonam Sharma, John Botzler, Eric Michael Genden, Erin Moshier, Isaiah Selkridge, Marshall R. Posner; Harvard University T H Chan School of Public Health, Boston, MA; New Jersey Medical School, Middletown, NJ; Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY; Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute, New York, NY; Department of Otolaryngology, Mount Sinai Medical Center, New York, NY; Mount Sinai School of Medicine, New York, NY; The Ohio State University, Columbus, OH; Mount Sinai Hospital, New York, NY; Mount Sinai, New York, NY; Icahn School of Medicine at Mount Sinai, New York, NY
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