Adjuvant chemoradiation therapy with high-dose versus weekly cisplatin for resected, locally-advanced HPV/p16-positive and negative head and neck squamous cell carcinoma

Jessica L. Geiger, Ahmed F. Lazim, Francis J. Walsh, Robert L. Foote, Eric J. Moore, Scott H. Okuno, Kerry D. Olsen, Jan L. Kasperbauer, Daniel L. Price, Yolanda I. Garces, Daniel J. Ma, Michelle A. Neben-Wittich, Julian R. Molina, Joaquin J. Garcia, Katharine A.R. Price

Research output: Contribution to journalArticle

33 Scopus citations

Abstract

Objectives Standard treatment for patients with poor-risk, resected head and neck squamous cell carcinoma (HNSCC) is adjuvant radiation therapy combined with high-dose cisplatin. Many patients are treated with weekly cisplatin; it is not known whether weekly and high-dose cisplatin are equivalent. This study compares the outcomes of patients with locally-advanced HPV-negative HNSCC and HPV/p16-positive oropharynx HNSCC treated with adjuvant chemoradiation therapy with either high-dose or weekly cisplatin. Materials and methods Retrospective review of patients with Stage III/IV HNSCC who had surgery followed by adjuvant chemoradiation therapy at Mayo Clinic, Rochester. HPV and/or p16 status was available for all oropharynx patients. Results 104 Patients (51 high-dose, 53 weekly) were analyzed. The 3-year overall survival was 84% and 75% for patients who received high dose and weekly cisplatin, respectively (p = 0.30). The 3-year recurrence free survival was 71% and 74% in the high dose and weekly cisplatin group, respectively (p = 0.95). Patients with HPV/p16-positive oropharynx cancer who received adjuvant chemoradiation therapy with high-dose and weekly cisplatin had three-year overall survival rates of 91% and 86% (p = 0.56), and 3-year recurrence free survival of 84% and 82% (p = 0.93). Extracapsular extension did not affect prognosis in either group. Conclusions No significant survival difference was seen between patients with locally advanced HNSCC treated with adjuvant chemoradiation therapy with high-dose or weekly cisplatin, although there was a trend for improved survival with high-dose cisplatin. Weekly cisplatin in the adjuvant setting may be a better treatment for patients with HPV-positive oropharynx cancer to preserve survival and minimize toxicity.

Original languageEnglish (US)
Pages (from-to)311-318
Number of pages8
JournalOral Oncology
Volume50
Issue number4
DOIs
StatePublished - Apr 2014

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Keywords

  • Adjuvant therapy
  • Cisplatin
  • Head and neck cancer
  • Human papillomavirus (HPV)
  • Oropharynx cancer
  • Radiotherapy

ASJC Scopus subject areas

  • Oral Surgery
  • Oncology
  • Cancer Research

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