Patient-reported quality-of-life outcomes after de-escalated chemoradiation for human papillomavirus-positive oropharyngeal carcinoma: Findings from a phase 2 trial : HPV-Positive Oropharyngeal Carcinoma

Abstract

<div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="section-title" id="d13740048e247">Purpose</h5> <p id="P1">This study represents a subset analysis of quality of life outcomes among patients treated on a phase II trial of de-escalated chemoradiation for human papillomavirus (HPV)-associated oropharynx cancer. </p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <h5 class="section-title" id="d13740048e252">Methods</h5> <p id="P2">Eligibility included newly-diagnosed, stage III or IV oropharyngeal squamous cell carcinoma, p16-positivity, age at least 18 years, and Zubrod performance status 0–1. Treatment was induction paclitaxel 175 mg/m ² and carboplatin AUC 6 for 2 cycles followed by response-adapted, dose-reduced radiation of 54 Gy or 60 Gy with weekly concurrent paclitaxel 30 mg/m ². The University of Washington Quality of Life (UW-QOL) and the Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&amp;N) questionnaires were used to assess patient-reported quality of life as a secondary endpoint. </p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <h5 class="section-title" id="d13740048e263">Results</h5> <p id="P3">Forty-five patients were registered, of whom 40 completed quality of life surveys and were evaluable. Nadirs for overall UW-QOL and FACT-H&amp;N scores were reached at 4 weeks after treatment but returned to baseline at 3 months. Nearly all functional indices returned to baseline levels by 6 to 9 months. The mean overall UW-QOL score was 71.6 at baseline compared to 70.8, 73.0, 83.3, and 81.1, at 3-months, 6-months, 1-year, and 2-years, respectively, post-therapy. The proportion rating their overall quality of life as “very good” or “outstanding” at 6-months, 1-year, and 2-years with the UW-QOL was 50%, 77%, and 84%, respectively. </p> </div><div class="section"> <a class="named-anchor" id="S4"> <!-- named anchor --> </a> <h5 class="section-title" id="d13740048e268">Conclusion</h5> <p id="P4">This de-escalation regimen achieved quality of life outcomes that were favorable compared to historical controls. These results serve as powerful evidence that ongoing de-escalation efforts lead to tangible gains in function and quality of life. </p> </div>