ESTRO 2022

Session Item

Head and neck

Session Type: Poster (digital)

Track: Clinical

Journey:

Long term outcomes of 630 consecutive patients of oropharyngeal cancer treated with radiotherapy

, India

Presentation Number: PO-1094

Abstract

Abstract Title:

Long term outcomes of 630 consecutive patients of oropharyngeal cancer treated with radiotherapy

Authors:

SHEETAL KASHID¹, Ashwini Budrukkar¹, Ajay Sasidharan¹, Manoj Mahimkar², Neha Mittal³, Usha Patel², Sarbani Ghosh-Laskar¹, Vedang Murthy¹, Tejpal Gupta¹, Asawari Patil³, Monali Swain¹, Naveen Mummudi¹, Munita Bal³, Kumar Prabhash⁴, Amit Joshi⁴, Vanita Noronha⁴, Vijay Patil⁴, Shwetabh Sinha¹, Anuj Kumar¹, Jai Prakash Agarwal¹

¹Tata Memorial Hospital, Radiation Oncology, Mumbai, India; ²Advanced Centre for treatment, Research and Education in Cancer, Pathology, Navi Mumbai, India; ³Tata Memorial Hospital, Pathology, Mumbai, India; ⁴Tata Memorial Hospital, Medical Oncology, Mumbai, India

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Purpose or Objective

To evaluate clinical outcomes, prognostic factors and the disease biology of oropharyngeal squamous cell cancer (OPSCC) treated with radiotherapy (RT) with or without concurrent chemotherapy.

Material and Methods

Six hundred thirty consecutive patients of OPSCC treated with RT with or without concurrent chemotherapy in a tertiary care centre from January 2013 to December 2017 were analysed to study various patient, disease and treatment related factors affecting the clinical outcomes. Descriptive analysis was used for demographics, Kaplan Meir method was used for survival analysis, Log rank test was used for univariate analysis (UVA) and Cox regression method was used for multivariate analysis (MVA).

Results

The median age at presentation was 56 years. Five hundred forty three (86.1%) patients were of locally advanced stage. HPV status was known for 297 patients of which 37(12.5%) tested p16 positive and 260(87.5%) were p16 negative. Chemo-radiotherapy was offered to 441(70%) patients. Intensity modulated radiotherapy (IMRT) technique was used for 163 (25.9%) patients. At median follow up for surviving patients of 54 months (IQR 37.7-68.3months) 5 year overall survival (OS), local control(LC), loco-regional control(LRC), disease free survival(DFS) were 37.1%, 48.3%, 36.1% & 30.9% respectively. At 5 year LC & LRC for stage I, II, III & IV were 62.5% & 62.5%, 58.9% & 53%, 55.7% & 45.5% and 43.4% & 29% respectively. Stage wise 5 year OS & DFS for stage I, II, III & IV were 58% & 62.5%, 54.3% & 44%, 49.2% & 43.8%, 30% & 23.6% respectively. HPV positive cohort showed significantly better outcomes with 5 year LC, LRC, DFS, OS was 84.6% vs 42.8% (p <0.001), 67.5% vs 29.4% ( p<0.001), 59.4% vs 25.8% (p <0.001), 62.6% vs 36.4% (p 0.004) in HPV positive and HPV negative cohort respectively. On UVA & MVA T1-T2 stage (AJCC 7^th ed.), early group stage (AJCC 7^th ed.), concurrent chemotherapy use, IMRT technique and radiotherapy dose >66Gy had statistically significant improvement for LC, LRC, DFS and OS.

Conclusion

HPV positivity was very low (12.5%) in our cohort of patients. HPV positive patients had significantly better clinical outcomes as compared to HPV negative OPSCC. In addition T stage, group stage, concurrent chemotherapy use, technique of RT, RT doses >66Gy were independent prognostic factors.