Differences in geometric patterns of failure in human papillomavirus (HPV)-associated and HPV-non-associated oropharyngeal cancer after definitive radiotherapy.

Autor: Yuvnik T; Calvary Mater Newcastle - Radiation Oncology, Waratah, New South Wales, Australia.; University of Sydney, Camperdown, New South Wales, Australia., Chia L; Canberra Region Cancer Centre, Garran, Australian Capital Territory, Australia., Laura OC; Calvary Mater Newcastle - Radiation Oncology, Waratah, New South Wales, Australia.; University of Newcastle, Newcastle, New South Wales, Australia., Tieu TT; Calvary Mater Newcastle - Radiation Oncology, Waratah, New South Wales, Australia.; University of Newcastle, Newcastle, New South Wales, Australia., Mahesh K; Calvary Mater Newcastle - Radiation Oncology, Waratah, New South Wales, Australia.; University of Newcastle, Newcastle, New South Wales, Australia., Bradley B; Calvary Mater Newcastle - Radiation Oncology, Waratah, New South Wales, Australia.; University of Newcastle, Newcastle, New South Wales, Australia., Daron C; University of Newcastle, Newcastle, New South Wales, Australia.; John Hunter Hospital - Surgical Services, New Lambton Heights, New South Wales, Australia.; Hunter Medical Research Institute, Newcastle, New South Wales, Australia., Chris W; Calvary Mater Newcastle - Radiation Oncology, Waratah, New South Wales, Australia.; University of Newcastle, Newcastle, New South Wales, Australia.
Jazyk: angličtina
Zdroj: Head & neck [Head Neck] 2024 Mar; Vol. 46 (3), pp. 552-560. Date of Electronic Publication: 2023 Dec 18.
DOI: 10.1002/hed.27606
Abstrakt: Introduction: The aim of this study was to evaluate and compare the spatial pattern of locoregional recurrences in patients diagnosed with HPV-associated and HPV-non-associated oropharyngeal SCC (OPSCC) treated with definitive radiotherapy.
Methods and Materials: Patients who had locoregional recurrence following definitive intensity-modulated radiation therapy were identified at a single tertiary institution. Target volumes were delineated according to the latest consensus international guidelines. Recurrences were classified into five categories based on radiotherapy dose distribution and target volume, using a previously validated methodology; type A (central high dose), type B (peripheral high dose), type C (central elective dose), type D (peripheral elective dose), and type E (extraneous dose). The types of failure were compared between p16-positive and p16-negative tumors using the Pearson chi-square test.
Results: Fifty-eight locoregional recurrences were observed in 36 patients. The majority of recurrences were in nodal locations (66%, 38/58). Among these, 34 (59%) were classified as type A, 6 (10%) as type B, 9 (15%) as type C, 5 (9%) as type D, and 4 (7%) as type E failure. A significant difference was found in the types of failure between p16-positive and p16-negative tumors (X 2 9.52, p = 0.044). p16-negative tumors were more likely to have recurrences in a peripheral location compared to p16-positive tumors (32% vs. 7%). p16-positive tumor were more likely to have extraneous recurrences (17% vs. 0%).
Conclusion: Our study results identified a significant difference in patterns of locoregional failure among patients diagnosed with oropharyngeal cancer following consensus-based tumor delineation and modern radiotherapy. Further confirmatory pattern of failure studies are required to enable greater individualization of radiotherapy for patients diagnosed with oropharyngeal malignancy in the future.
(© 2023 The Authors. Head & Neck published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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