title: Weekly chemotherapy with radiation versus high-dose cisplatin with radiation as organ preservation for patients with HPV-positive and HPV-negative locally advanced squamous cell carcinoma of the oropharynx.
abstract: BACKGROUND
  Optimal treatment for locally advanced squamous cell carcinoma of the oropharynx (SCCOP) is not well defined. Here we retrospectively compare survival and toxicities from 2 different organ preservation protocols.
  
  
  METHODS
  The matched dataset consisted of 35 patients from each trial matched for age, stage, smoking, and tumor human papillomavirus (HPV) status. Patients in the University of Michigan Cancer Center (UMCC) trial 9921 were treated with induction chemotherapy (IC) followed by high-dose cisplatin and radiation in responders or surgery in nonresponders. Patients in the UMCC trial 0221 were treated with weekly carboplatin and paclitaxel and radiation.
  
  
  RESULTS
  Survival was comparable for both studies and did not differ significantly across each trial after stratifying by HPV status. Grade 3 and 4 toxicities were more frequent in UMCC 9921. At 6 months posttreatment, gastrostomy tube (G-tube) dependence was not statistically different.
  
  
  CONCLUSIONS
  These data suggest that survival outcomes in patients with locally advanced SCCOP are not compromised with weekly chemotherapy and radiation therapy, and such treatment is generally more tolerable.
authors.affiliation: Department of Internal Medicine, University of Michigan, Ann Arbor, MI.
authors.forename: Irina Y
authors.initials: IY
authors.lastname: Dobrosotskaya
authors.forename: Emily
authors.initials: E
authors.lastname: Bellile
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Spector
authors.forename: Bhavna
authors.initials: B
authors.lastname: Kumar
authors.forename: Felix
authors.initials: F
authors.lastname: Feng
authors.forename: Avraham
authors.initials: A
authors.lastname: Eisbruch
authors.forename: Gregory T
authors.initials: GT
authors.lastname: Wolf
authors.forename: Mark E P
authors.initials: ME
authors.lastname: Prince
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Moyer
authors.forename: Theodoros
authors.initials: T
authors.lastname: Teknos
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Chepeha
authors.forename: Heather M
authors.initials: HM
authors.lastname: Walline
authors.forename: Jonathan B
authors.initials: JB
authors.lastname: McHugh
authors.forename: Kitrina G
authors.initials: KG
authors.lastname: Cordell
authors.forename: P Daniel
authors.initials: PD
authors.lastname: Ward
authors.forename: Serena
authors.initials: S
authors.lastname: Byrd
authors.forename: Jessica H
authors.initials: JH
authors.lastname: Maxwell
authors.forename: Susan
authors.initials: S
authors.lastname: Urba
authors.forename: Carol R
authors.initials: CR
authors.lastname: Bradford
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Carey
authors.forename: Francis P
authors.initials: FP
authors.lastname: Worden
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016190:Carboplatin / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000821:virology; D002945:Cisplatin / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D052163:Human papillomavirus 6 / Q000302:isolation & purification*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D009926:Organ Preservation; D009959:Oropharyngeal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D017239:Paclitaxel / Q000627:therapeutic use; D016016:Proportional Hazards Models; D011446:Prospective Studies; D020551:Pulse Therapy, Drug / Q000379:methods; D011882:Radiotherapy, High-Energy / Q000379:methods; D018570:Risk Assessment; D012698:Serologic Tests; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin
keywords: HPV; chemoradiation; oropharynx; toxicity; weekly