1. Impact of cisplatin dose and smoking pack-years in human papillomavirus-positive oropharyngeal squamous cell carcinoma treated with chemoradiotherapy.
- Author
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Oliva M, Huang SH, Xu W, Su J, Hansen AR, Bratman SV, Ringash J, Jang R, Cho J, Bayley A, Hope AJ, Chen E, Giuliani M, Waldron J, Weinreb I, Perez-Ordonez B, Chepeha D, Kim J, O Sullivan B, Siu LL, and Spreafico A
- Subjects
- Adult, Aged, Antineoplastic Agents adverse effects, Cisplatin adverse effects, Disease Progression, Female, Humans, Male, Middle Aged, Neoplasm Staging, Ontario, Oropharyngeal Neoplasms mortality, Oropharyngeal Neoplasms pathology, Oropharyngeal Neoplasms virology, Progression-Free Survival, Retrospective Studies, Risk Assessment, Risk Factors, Squamous Cell Carcinoma of Head and Neck mortality, Squamous Cell Carcinoma of Head and Neck pathology, Squamous Cell Carcinoma of Head and Neck virology, Time Factors, Antineoplastic Agents administration & dosage, Chemoradiotherapy adverse effects, Cigarette Smoking adverse effects, Cisplatin administration & dosage, Oropharyngeal Neoplasms therapy, Papillomaviridae isolation & purification, Squamous Cell Carcinoma of Head and Neck therapy
- Abstract
Background: To evaluate the impact of cisplatin cumulative dose (CDDP-D) and smoking pack-years (PYs) on cause-specific survival (CSS) and overall survival (OS) in human papillomavirus-positive (HPV+) oropharyngeal carcinoma (OPSCC) using the eighth edition tumour-node-metastasis (TNM) staging classification (TNM8)., Patients and Methods: We reviewed patients with HPV+ OPSCC treated with high-dose CDDP and intensity-modulated radiotherapy between 2005 and 2015 at Princess Margaret Cancer Centre. CSS and OS were compared according to CDDP-D <200/=200/>200 mg/m
2 stratified by TNM8., Results: A total of 482 consecutive patients were evaluated (stage I/II/III: N = 189/174/119; CDDP-D <200/=200/>200 mg/m2 : N = 112/220/150). Median follow-up duration was 5.1 years (range: 0.6-12.8). Five-year CSS and OS differed by stages I/II/III: 96%/85%/88% (p=0.005) and 93%/84%/78% (p = 0.001), respectively. Five-year CSS by CDDP-D <200/=200/>200 mg/m2 was similar in stage I (98%/95%/95%, p = 0.74) and stage II (88%/84%/84%, p = 0.86) but different in stage III (76%/98%/84%, p = 0.02). Five-year OS by CDDP-D <200/=200/>200 mg/m2 did not differ significantly among stages. In the multivariable analysis, CDDP-D <200 mg/m2 did not influence CSS in the whole cohort versus = 200/>200 mg/m2 (p=0.53/0.79, respectively) but was associated with reduced CSS in stage III subgroup versus =200 mg/m2 (=200 mg/m2 versus < 200 mg/m2 hazard ratio [HR] = 0.08; 95% confidence interval [CI]: 0.01-0.67; p = 0.02). Higher smoking PYs had no effect on CSS (p = 0.34) but reduced OS in the whole cohort (HR = 1.14 [95% CI: 1.02-1.27], p=0.01)., Conclusion: CDDP-D correlated with neither survival nor disease-specific outcomes in this large and homogeneous HPV+ cohort, although reduced CSS was observed in stageIII HPV+ OPSCC receiving CDDP-D <200 mg/m2 . Smoking PYs were negatively associated with OS but not with CSS., (Copyright © 2019 Elsevier Ltd. All rights reserved.)- Published
- 2019
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