Reducing Radiation Dose in Oropharynx Cancer Can Improve QOL

A new clinical study to reduce the unwanted side effects of radiation in patients with human papillomavirus (HPV)—positive oropharynx cancers has found that reducing the dose of radiation can maintain the cure rates but avoid some of the late treatment-associated toxicities.

HPV-positive oropharynx cancers develop in the tonsils and the back of the throat. Radiation administered to treat these cancers often results in sever issues with swallowing, eating, and nutrition. The questions is, can these toxicities be avoided while maintaining the cure rate?

To test this hypothesis, researchers enrolled 80 patients from 16 ECOG-ACRIN Cancer Research Group sites, who were diagnosed with stage 3 or 4 HPV—positive squamous cell carcinoma of the oropharynx. Patients received 3 courses of induction chemotherapy with cisplatin, paclitaxel, and cetuximab. Those who had a good clinical response then received reduced doses of radiation. Those who received lower dose of radiation had less difficulty swallowing solid food compared with those who received the regular dose (40% versus 89%, respectively). Further, only 10% of those who received the lower dose had impaired nutrition, compared with 44% of those who received the regular radiation dose.

Considering that a lot of younger patients are presenting with HPV-positive squamous cell carcinoma of the oropharynx, their long-term quality of life is extremely important. “Younger patients may have to deal with these side effects for decades after cancer treatment. We want to help improve our patients’ quality of life,” said Barbara Burtness, MD, professor of Medicine, Yale Cancer Center, Disease Research Team Leader for the Head and Neck Cancers Program at Smilow Cancer Hospital.

The study has been published in the Journal of Clinical Oncology.