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Risk of recurrence after neoadjuvant chemotherapy and transoral robotic surgery in patients with oropharynx cancer that avoid adjuvant radiation.
Pershad, Alisha R; Thakkar, Punam G; Goodman, Joseph F; Joshi, Arjun; Steinberg, Seth M; Allen, Clint T; Floudas, Charalampos S.
Afiliação
  • Pershad AR; Division of Otolaryngology-Head and Neck Surgery, The George Washington University School of Medicine & Health Sciences, Washington, DC, USA.
  • Thakkar PG; Division of Otolaryngology-Head and Neck Surgery, The George Washington University School of Medicine & Health Sciences, Washington, DC, USA.
  • Goodman JF; Division of Otolaryngology-Head and Neck Surgery, The George Washington University School of Medicine & Health Sciences, Washington, DC, USA.
  • Joshi A; Division of Otolaryngology-Head and Neck Surgery, The George Washington University School of Medicine & Health Sciences, Washington, DC, USA.
  • Steinberg SM; Astrix Technology, LLC, contractor to Biostatistics and Data Management Section, Office of the Clinical Director, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
  • Allen CT; Surgical Oncology Program, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
  • Floudas CS; Center for Immuno-Oncology, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
Cancer Med ; 13(7): e7146, 2024 Apr.
Article em En | MEDLINE | ID: mdl-38581118
ABSTRACT

BACKGROUND:

De-escalation strategies for newly-diagnosed p16-positive oropharyngeal squamous cell carcinoma (p16+ OPSCC), aim to reduce treatment-related morbidity without compromising disease control. One strategy is neoadjuvant cisplatin and docetaxel chemotherapy (NAC + S) before transoral robotic surgery, with pathology-based risk-adapted adjuvant treatment.

METHODS:

We examined the recurrence-free survival (RFS) for patients who received NAC + S.

RESULTS:

Comparing outcomes in 103 patients between 2008 and 2023, 92% avoided adjuvant treatment and showed significantly higher 2-year recurrence-free survival (RFS) compared to those with adjuvant treatment (95.9% vs. 43.8%, p = 0.0049)

CONCLUSION:

Our findings suggest that pathology-based risk-adapted omission of adjuvant treatment following NAC + S does not appear to elevate recurrence risk and that NAC may identify patients with favorable tumor biology, yielding a 2-year RFS probability exceeding 95% without adjuvant treatment. Further, the study identifies a patient subset experiencing disease recurrence despite triple modality therapy. Despite limitations, including a retrospective design and modest sample size, the data advocate for controlled NAC + S studies.
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Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 1_ASSA2030 / 2_ODS3 Base de dados: MEDLINE Assunto principal: Carcinoma de Células Escamosas / Neoplasias Orofaríngeas / Procedimentos Cirúrgicos Robóticos / Neoplasias de Cabeça e Pescoço Limite: Humans Idioma: En Revista: Cancer Med Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Contexto em Saúde: 1_ASSA2030 / 2_ODS3 Base de dados: MEDLINE Assunto principal: Carcinoma de Células Escamosas / Neoplasias Orofaríngeas / Procedimentos Cirúrgicos Robóticos / Neoplasias de Cabeça e Pescoço Limite: Humans Idioma: En Revista: Cancer Med Ano de publicação: 2024 Tipo de documento: Article