Induction chemotherapy followed by concurrent chemoradiotherapy for advanced stage oropharyngeal squamous cell carcinoma with hpv and p16 testing

Eric Flavill, Yisheng V. Fang, Brett Miles, John Truelson, Steve Perkins

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Objective: The objective was to report our experience with advanced stage oropharyngeal squamous cell carcinoma treated sequentially with induction chemotherapy followed by concurrent chemoradiotherapy. Methods: Retrospective chart review identified 49 eligible patients with advanced stage oropharyngeal squamous cell carcinoma treated with induction chemotherapy followed by concurrent chemoradiotherapy. HPV and p16INK4A testing was performed on pathology specimens. Follow-up of over 11 months was required unless a death or treatment failure occurred before that time. Results: Treatment with induction chemotherapy followed by concurrent chemoradiotherapy resulted in 44/48 (90%) complete durable response. One death occurred from pulmonary embolism. Toxicity profiles were comparable to other published data. Average follow-up was 3.9 years. Oncologic failure rates among subgroups showed 5.7% failure for HPV+/ p16+ cancer, 9.1% failure for HPV-/p16+ cancer, 100% failure for HPV-/p16- cancer, 0% failure for nonsmokers, and 17.9% failure for smokers. Conclusions: This study showed favorable outcomes in terms of durable oncologic response and acceptable toxicity profiles. It is notable that 36/49 patients were HPV+/p16+ and 11/49 were HPV-/p16+. Only 2 patients were HPV-/p16-, and both died as a result of oncologic failures. This highlights the importance of obtaining HPV and p16 testing in studies evaluating the efficacy of treatments for oropharyngeal squamous cell carcinoma.

Original languageEnglish (US)
Pages (from-to)365-373
Number of pages9
JournalAnnals of Otology, Rhinology and Laryngology
Volume123
Issue number5
DOIs
StatePublished - May 2014

Keywords

  • Human papilloma virus
  • Induction chemotherapy
  • Oropharyngeal squamous cell carcinoma
  • P16
  • Sequential chemotherapy

ASJC Scopus subject areas

  • Otorhinolaryngology

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