| Autor: |
Katharine, Price, Kathryn M, Van Abel, Eric J, Moore, Samir H, Patel, Michael L, Hinni, Ashish V, Chintakuntlawar, Darlene, Graner, Michelle, Neben-Wittich, Yolanda I, Garces, Daniel L, Price, Jeffrey R, Janus, Nathan R, Foster, Brenda F, Ginos, Robert L, Foote, Daniel, Ma |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
International Journal of Radiation Oncology*Biology*Physics. 114:256-265 |
| ISSN: |
0360-3016 |
| Popis: |
Patients with human papillomavirus oropharyngeal cancer are highly curable but risk significant long-term toxic effects with standard therapy. This study investigated a de-escalation strategy of decreased adjuvant radiation therapy and chemotherapy after transoral robotic surgery, and reports on long-term functional and quality of life (QOL) outcomes.Eligible patients had a p16-positive oropharyngeal cancer and ≤10 pack-year smoking history and underwent surgery followed by treatment with either 30 Gy delivered in 1.5-Gy fractions twice per day over 2 weeks with weekly docetaxel (15 mg/mSeventy-nine patients (89.9% male) were treated and eligible for toxic effect and functional evaluation. Dry mouth was the most common grade 1 toxic effect at 1 year (55.6%), 2 years (53.3%), and 3 years (49.2%). The cumulative rates of grade 2 toxic effects at 1, 2, and 3 years were 1.4%, 6.7%, and 6.8%, respectively. There were only 2 grade 3 toxic effects at ≥1 year, including a grade 3 fatigue at 2.5 years, and a grade 3 superficial soft tissue fibrosis at 4 years. There were no grade 4 to 5 toxic effects. No patients were percutaneous endoscopic gastrostomy-dependent. Swallow function improved by 12 months posttreatment. QOL improved over time by all measurement tools and most patients returned to baseline level of function and QOL.De-escalated adjuvant therapy for select patients with human papillomavirus oropharyngeal cancer resulted in low rates of long-term toxic effects, excellent swallow outcomes, and preservation of global and xerostomia-related QOL. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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