Impact of cisplatin dose and smoking pack-years in human papillomavirus-positive oropharyngeal squamous cell carcinoma treated with chemoradiotherapy.

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/m2 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.

• Authors: Marc Oliva, Shao Hui Huang, Wei Xu, Jie Su, Aaron R Hansen, Scott V Bratman, Jolie Ringash, Raymond Jang, John Cho, Andrew Bayley, Andrew J Hope, Eric Chen, Meredith Giuliani, John Waldron, Ilan Weinreb, Bayardo Perez-Ordonez, Douglas Chepeha, John Kim, Brian O Sullivan, Lillian L Siu, Anna Spreafico
• Journal: European journal of cancer (Oxford, England : 1990) (Eur J Cancer) Vol. 118 Pg. 112-120 (09 2019) ISSN: 1879-0852 [Electronic] England
• PMID: 31330486 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2019 Elsevier Ltd. All rights reserved.

Chemical References

• Antineoplastic Agents
• Cisplatin

Topics

• Adult
• Aged
• Antineoplastic Agents (administration & dosage, adverse effects)
• Chemoradiotherapy (adverse effects)
• Cigarette Smoking (adverse effects)
• Cisplatin (administration & dosage, adverse effects)
• Disease Progression
• Female
• Humans
• Male
• Middle Aged
• Neoplasm Staging
• Ontario
• Oropharyngeal Neoplasms (mortality, pathology, therapy, virology)
• Papillomaviridae (isolation & purification)
• Progression-Free Survival
• Retrospective Studies
• Risk Assessment
• Risk Factors
• Squamous Cell Carcinoma of Head and Neck (mortality, pathology, therapy, virology)
• Time Factors