- Dose de-escalation of adjuvant radiotherapy (ART) from 60-66 Gy to 30-36 Gy is associated with similar locoregional control rates as historically reported for patients with human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC).
Why this matters
- Aggressive ART de-escalation is a strategy for reducing toxicity while maintaining cure rates.
- The 2-year locoregional control (LRC) rate was 96.2%.
- 2-year distant metastasis-free survival was 94.9%, 2-year PFS was 91.1%, and 2-year OS was 98.7%.
- Rates of grade 3+ toxicity were 2.5% at pre-RT, 0.0% at 1 year, and 0.0% at 2 years.
- At 1-year posttreatment, QoL improved compared with pre-RT (FACT-HN, EORTC-QLQ HN35, and EQ-5D-3L; P<.001 for all>
- At 1-year posttreatment, swallowing function improved compared with pre-RT (pharyngeal total modified barium swallow impairment profile and diet normalcy, as measured by the Functional Oral Intake Scale; P=.01 for both).
- Phase 2 trial of 80 patients with HPV-associated OPSCC and negative margins.
- Intermediate-risk patients received 1.5-Gy fractions twice daily over the course of 2 weeks+15 mg/m2 docetaxel once weekly; patients with extranodal extension also received a simultaneous integrated boost to 36 Gy in 1.8-Gy fractions twice daily.
- Funding: NIH; Braillier Family Research Fund; Matteson Research Fund.
- Singe-group trial.
- Small patient sample size.