AUTHOR=Takahashi Mai , Hwang Michael , Misiukiewicz Krysztof , Gupta Vishal , Miles Brett A. , Bakst Richard , Genden Eric , Selkridge Isaiah , Botzler John , Virani Vruti , Moshier Erin , Bonomi Marcelo R. , Posner Marshall R. 

TITLE=Quality of Life Analysis of HPV-Positive Oropharyngeal Cancer Patients in a Randomized Trial of Reduced-Dose Versus Standard Chemoradiotherapy: 5-Year Follow-Up

JOURNAL=Frontiers in Oncology

VOLUME=Volume 12 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.859992

DOI=10.3389/fonc.2022.859992

ISSN=2234-943X

ABSTRACT=Background: Human Papillomavirus-positive oropharyngeal carcinoma (HPVOPC) portends a more favorable prognosis compared to environmentally-related oropharynx cancer (EROPC). Patients with HPVOPC may be overtreated and endure unnecessary long-term toxicities. 
Methods: Patients with untreated, locally-advanced HPVOPC received induction chemotherapy with docetaxel, cisplatin, and 5-fluorouracil and were randomized to sdCRT (70 Gy) or rdCRT (56 Gy) with weekly carboplatin. Patients were followed for 5-year progression-free survival (PFS), overall survival (OS), and changes in five validated quality of life (QoL) surveys.
Results: Twenty patients were enrolled and randomized to rdCRT (n=12) or sdCRT (n=8). Median follow-up was 88 months. 5-year PFS/OS were 87.5%/83.3% for sdCRT and rdCRT respectively. At 5 years follow up, difference in QoL changes all favored the rdCRT arm and two QoL scales reached statistical significance.
Conclusions: rdCRT after TPF in HPVOPC is feasible. These limited results demonstrate equivalent long-term survival compared to sdCRT and are more favorable in specific QoL domains.