Dose Escalation of Oropharyngeal Cancer: Long-Time Follow-Up and Side Effects
Previous studies on dose-escalated radiotherapy in head and neck cancer have shown mixed results, and it is not established which patients would benefit from dose escalation. Further, while dose escalation does not appear to increase late toxicity, this needs to be confirmed with longer follow-up. I...
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MDPI AG
2023-04-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/9/2580 |
| _version_ | 1797602863101247488 |
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| author | Anna Embring Eva Onjukka Claes Mercke Ingmar Lax Anders Berglund Signe Friesland |
| author_facet | Anna Embring Eva Onjukka Claes Mercke Ingmar Lax Anders Berglund Signe Friesland |
| author_sort | Anna Embring |
| collection | DOAJ |
| description | Previous studies on dose-escalated radiotherapy in head and neck cancer have shown mixed results, and it is not established which patients would benefit from dose escalation. Further, while dose escalation does not appear to increase late toxicity, this needs to be confirmed with longer follow-up. In this study, we analysed treatment outcome and toxicity in 215 patients with oropharyngeal cancer treated with dose-escalated radiotherapy (>72 Gy, EQD2, α/β = 10 Gy, boost by brachytherapy or simultaneous integrated boost) and a matched cohort of 215 patients treated with standard dose external-beam radiotherapy (68 Gy) between 2011 and 2018 at our institution. The 5-year overall survival (OS) was 77.8% (72.4–83.6) and 73.7% (67.8–80.1) in the dose-escalated and standard dose group, respectively (<i>p</i> = 0.24). Median follow-up was 78.1 (49.2–98.4) and 60.2 (38.9–89.4) months in the dose-escalated and standard dose groups, respectively. Grade ≥3 osteoradionecrosis (ORN) and late dysphagia were more common in the dose-escalated group compared to the standard dose group, with 19 (8.8%) vs. 4 (1.9%) patients developing grade ≥3 ORN (<i>p</i> = 0.001), and 39 (18.1%) vs. 21 (9.8%) patients developing grade ≥3 dysphagia (<i>p</i> = 0.01). No predictive factors to help select patients for dose-escalated radiotherapy were found. However, the remarkably good OS in the dose-escalated cohort, despite a predominance of advanced tumour stages, encourages further attempts to identify such factors. |
| first_indexed | 2024-03-11T04:22:32Z |
| format | Article |
| id | doaj.art-b77a19cbe958432cac8cb0b5c71bf1d1 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T04:22:32Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-b77a19cbe958432cac8cb0b5c71bf1d12023-11-17T22:41:42ZengMDPI AGCancers2072-66942023-04-01159258010.3390/cancers15092580Dose Escalation of Oropharyngeal Cancer: Long-Time Follow-Up and Side EffectsAnna Embring0Eva Onjukka1Claes Mercke2Ingmar Lax3Anders Berglund4Signe Friesland5Department of Oncology, Karolinska University Hospital, 17176 Stockholm, SwedenKarolinska Institute, Department of Oncology-Pathology, 17176 Stockholm, SwedenDepartment of Oncology, Karolinska University Hospital, 17176 Stockholm, SwedenKarolinska Institute, Department of Oncology-Pathology, 17176 Stockholm, SwedenEpistat Epidemiology and Statistics Consulting, 75655 Uppsala, SwedenDepartment of Oncology, Karolinska University Hospital, 17176 Stockholm, SwedenPrevious studies on dose-escalated radiotherapy in head and neck cancer have shown mixed results, and it is not established which patients would benefit from dose escalation. Further, while dose escalation does not appear to increase late toxicity, this needs to be confirmed with longer follow-up. In this study, we analysed treatment outcome and toxicity in 215 patients with oropharyngeal cancer treated with dose-escalated radiotherapy (>72 Gy, EQD2, α/β = 10 Gy, boost by brachytherapy or simultaneous integrated boost) and a matched cohort of 215 patients treated with standard dose external-beam radiotherapy (68 Gy) between 2011 and 2018 at our institution. The 5-year overall survival (OS) was 77.8% (72.4–83.6) and 73.7% (67.8–80.1) in the dose-escalated and standard dose group, respectively (<i>p</i> = 0.24). Median follow-up was 78.1 (49.2–98.4) and 60.2 (38.9–89.4) months in the dose-escalated and standard dose groups, respectively. Grade ≥3 osteoradionecrosis (ORN) and late dysphagia were more common in the dose-escalated group compared to the standard dose group, with 19 (8.8%) vs. 4 (1.9%) patients developing grade ≥3 ORN (<i>p</i> = 0.001), and 39 (18.1%) vs. 21 (9.8%) patients developing grade ≥3 dysphagia (<i>p</i> = 0.01). No predictive factors to help select patients for dose-escalated radiotherapy were found. However, the remarkably good OS in the dose-escalated cohort, despite a predominance of advanced tumour stages, encourages further attempts to identify such factors.https://www.mdpi.com/2072-6694/15/9/2580radiotherapydose escalationoropharyngeal cancerhead and neck cancerside effectsosteoradionecrosis |
| spellingShingle | Anna Embring Eva Onjukka Claes Mercke Ingmar Lax Anders Berglund Signe Friesland Dose Escalation of Oropharyngeal Cancer: Long-Time Follow-Up and Side Effects Cancers radiotherapy dose escalation oropharyngeal cancer head and neck cancer side effects osteoradionecrosis |
| title | Dose Escalation of Oropharyngeal Cancer: Long-Time Follow-Up and Side Effects |
| title_full | Dose Escalation of Oropharyngeal Cancer: Long-Time Follow-Up and Side Effects |
| title_fullStr | Dose Escalation of Oropharyngeal Cancer: Long-Time Follow-Up and Side Effects |
| title_full_unstemmed | Dose Escalation of Oropharyngeal Cancer: Long-Time Follow-Up and Side Effects |
| title_short | Dose Escalation of Oropharyngeal Cancer: Long-Time Follow-Up and Side Effects |
| title_sort | dose escalation of oropharyngeal cancer long time follow up and side effects |
| topic | radiotherapy dose escalation oropharyngeal cancer head and neck cancer side effects osteoradionecrosis |
| url | https://www.mdpi.com/2072-6694/15/9/2580 |
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