Comparisons of dysphagia and quality of life (QOL) in comparable patients with HPV-positive oropharyngeal cancer receiving chemo-irradiation or cetuximab-irradiation

Stuart E. Samuels, Yebin Tao, Teresa Lyden, Marc Haxer, Matthew Spector, Kelly M. Malloy, Mark E. Prince, Carol R. Bradford, Francis P. Worden, Matthew Schipper, Avraham Eisbruch

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Purpose Compare functional outcomes of radiotherapy (RT) concurrent with cetuximab (cet-RT) or with chemotherapy (chemo-RT) for comparable, good prognosis patients with human papillomavirus related (HPV+) oropharyngeal cancer (OPC). Methods Outcomes of patients with stage III/IV HPV+ OPC patients with minimal smoking history and non-T4/N3/N2C, treated on prospective protocol of RT concurrent with cetuximab (cet-RT), were compared to similar patients on prospective chemo-RT protocols. In both groups, videofluoroscopy (VF), observer rated dysphagia (ORD), and validated QOL questionnaires: xerostomia questionnaire (XQ), head and neck QOL, and University of Washington QOL, were performed periodically and compared to pretreatment. Mixed effects models with adjustment for baseline assessed differences between groups. Results 26 cet-RT patients were compared to 27 chemo-RT patients with similar baseline characteristics. In the chemo-RT group, no recurrences occurred. In the cet-RT group, 1 patient had persistent microscopic disease on salvage neck dissection and 1 distant failure. Both groups had mild VF-based swallowing dysfunction pre-treatment, worsened at 3 months (P < 0.02) and persisted at 12 months, not differing between groups (P > 0.11). For both groups ORD was very low pretreatment, worsened at 3 months and improved at 12 months, without differences between treatment groups (P = 0.26). QOL Summary and domain scores for eating were good pretreatment, worse at 3 mo, and then improved to near baseline at 12 months, without differences between the groups in any QOL domains (P > 0.10). Conclusion Both groups had excellent clinical outcomes without significant differences in objective or subjective functions. These data question using cetuximab instead of chemotherapy for treatment de-intensification for HPV+ OPC.

Original languageEnglish (US)
Pages (from-to)68-74
Number of pages7
JournalOral oncology
Volume54
DOIs
StatePublished - Mar 2016
Externally publishedYes

Keywords

  • Cetuximab
  • Chemo-RT
  • Oropharyngeal cancer
  • Quality of life
  • Swallowing

ASJC Scopus subject areas

  • Oral Surgery
  • Oncology
  • Cancer Research

Fingerprint

Dive into the research topics of 'Comparisons of dysphagia and quality of life (QOL) in comparable patients with HPV-positive oropharyngeal cancer receiving chemo-irradiation or cetuximab-irradiation'. Together they form a unique fingerprint.

Cite this