Lower-level radiation and chemotherapy may be as effective as standard doses for some patients with human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC), and may cause fewer side effects, according to findings presented at the annual meeting of the American Society for Radiation Oncology (ASTRO), held from Oct. 18 to 21 in San Antonio.

The study included 43 patients who had favorable-risk HPV-associated OPSCC and were not heavy smokers. Compared to standard treatment, their radiation therapy was reduced by 16 percent and their chemotherapy dose was reduced by 60 percent.

The researchers found that after an average follow-up of nearly 21 months (range of 6 to 36 months), all of the patients were alive with no evidence of cancer recurrence.


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The patients had fewer side effects — such as mouth dryness, dysphagia, nausea, vomiting, and mucositis — compared with patients who received standard treatment.

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Only 39 percent of the patients in the study required feeding tubes, none of which were permanent, versus rates of up to 80 percent (about 10 percent permanent) for patients receiving standard treatment.

“Our study provides strong preliminary evidence that reduced-intensity chemoradiotherapy may be as effective as standard-dose chemoradiotherapy,” lead author Bhishamjit Chera, M.D., associate professor of radiation oncology at the University of North Carolina School of Medicine in Chapel Hill, said in an ASTRO news release.

Reference

  1. Chera BS, Amdur RJ, Tepper JE, et al. A Prospective Phase II Trial of Deintensified Chemoradiation Therapy for Low Risk HPV Associated Oropharyngeal Squamous Cell Carcinoma. International Journal of Radiation Oncology. November 2015. DOI: http://dx.doi.org/10.1016/j.ijrobp.2015.07.011.