Patient perspectives and treatment regret after de-escalated chemoradiation for human papillomavirus-positive oropharyngeal cancer: Findings from a phase II trial

Head Neck. 2019 Aug;41(8):2768-2776. doi: 10.1002/hed.25760. Epub 2019 Apr 8.

Abstract

Background: We evaluated priorities, expectations, and regret among patients treated on a phase II trial of de-escalated chemoradiation for human papillomavirus (HPV)-positive oropharyngeal cancer.

Methods: Eligibility included stage III/IV squamous cell carcinoma of the oropharynx, p16-positivity, age ≥18 years, and Zubrod score 0-1. Participants were surveyed with validated measures evaluating their treatment experience.

Results: Twenty-four of 27 (89%) patients participated with a median follow-up of 24 months. Twenty-three subjects (96%) selected "being cured" or "living as long as possible" as top priority. No patient reported any regret about the decision to enroll on a de-escalation protocol. Sixteen participants (67%) found retrospectively reported long-term swallowing function to be either better than or as originally expected.

Conclusions: These data offer a baseline landscape of perspectives and priorities for patients treated with de-escalation for HPV-positive oropharyngeal carcinoma and provide support to the fundamental premise underlying ongoing efforts to establish a new standard of care.

Keywords: de-escalation; human papillomavirus; oropharyngeal cancer; patient perspective; priorities.

Publication types

  • Clinical Trial, Phase II

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / therapy*
  • Carcinoma, Squamous Cell / virology
  • Chemoradiotherapy / adverse effects
  • Chemoradiotherapy / methods*
  • Deglutition
  • Female
  • Follow-Up Studies
  • Human papillomavirus 16 / isolation & purification
  • Humans
  • Male
  • Middle Aged
  • Oropharyngeal Neoplasms / therapy*
  • Oropharyngeal Neoplasms / virology
  • Patient Reported Outcome Measures
  • Patient Satisfaction*
  • Radiotherapy Dosage
  • Surveys and Questionnaires