Abstract
Objectives:
The most common chemoradiotherapy regimen is high-dose (100mg/m2) three-weekly cisplatin with concomitant radiotherapy; however, this protocol is associated with acute and late toxicities. Recent study demonstrated that human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) patients showed good prognosis. We reviewed the efficacy for concomitant weekly cisplatin and radiotherapy in patients with HPV-positive OPSCC.
Methods:
Twenty-two patients with untreated OPSCC were enrolled and evaluated at our institution from July 2006 to June 2012. Weekly cisplatin (40mg/m2) was given on weeks 1,2,3,5,6 and 7 with radiotherapy, which comprised a standard dose of 70 Gy delivered in 35 daily fractions over 7 weeks. The presence of HPV was analyzed using multiplex PCR method. Median follow-up time was 26 months for surviving patients.
Results:
Of the 22 oropharyngeal carcinomas, 13 (59%) were HPV-positive. Twenty-one patients (95.4%) received the full dose of radiotherapy. Over the course of the chemotherapy, 14 patients (63.6%) received more than 200 mg/m2 cisplatin. The acute and late toxicity was manageable in all cases. HPV-positive patients had better two-year-overall survival rates (90.0% vs 66.7%) than HPV-negative patients. For patients who were HPV-positive, 1 of 13 died of distant metastasis, but those who were HPV-negative, 1 of 9 died of local recurrence and 2 of 9 died of distant metastasis.
Conclusions:
Because of its favorable outcome and less toxicity, concomitant weekly cisplatin and radiotherapy appears to be suitable treatment for HPV-positive OPSCC.
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