title: High-dose versus weekly cisplatin definitive chemoradiotherapy for HPV-related oropharyngeal squamous cell carcinoma of the head and neck.
abstract: To compare the outcomes and toxicity of high-dose cisplatin (HDC) versus weekly cisplatin (WC) definitive chemoradiotherapy (CRT) for patients with human papillomavirus (HPV) related oropharyngeal squamous cell carcinoma (SCCOPx).
  
  
  
  All patients with p16 positive SCCOPx treated with definitive CRT with cisplatin between 2010 and 2014 at a single institution were retrospectively reviewed. CTCAE v 4.03 toxicity criteria were used. The Kaplan-Meier method was used to estimate event-free survival (EFS) and the overall survival (OS).
  
  
  
  Of the 55 patients included, 22 were patients treated with HDC at dose of 100mg/m2on days 1 and 22; and the remaining 33 patients were treated with WC at 40mg/m2. Both cohorts received a median total dose of cisplatin of 200mg/m2. At median follow-up of 31months, there was one local failure and no distant failures in the HDC cohort. In the WC group, there were 6 total failures (2 local, 4 distant). Estimated 2-year EFS was better in HDC cohort as compared to WC (96% vs. 75%; p=0.04). There was no significant difference in 2-year OS (95% vs. 94%; p=0.40). Weight loss, gastric tube dependence at six months, acute renal injury and grade 3 or 4 hematological toxicity were all similar between both groups.
  
  
  
  HPV-related SCCOPx treated with definitive CRT with either HDC or WC had similar toxicity profile. HDC had better EFS when compared with WC and this seems to be driven by increased distant failure rates, although the OS was similar.
authors.affiliation: Division of Medical Oncology and Hematology, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, United States. Electronic address: capere06@louisville.edu.
authors.forename: Cesar Augusto
authors.initials: CA
authors.lastname: Perez
authors.affiliation: Biostatistics Shared Facility, JG Brown Cancer Center, University of Louisville, KY, United States.
authors.forename: Xiaoyong
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Radiation Oncology, University of Louisville, Louisville, KY, United States.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Amsbaugh
authors.affiliation: Division of Medical Oncology and Hematology, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, United States.
authors.forename: Rahul
authors.initials: R
authors.lastname: Gosain
authors.affiliation: Division of Medical Oncology and Hematology, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, United States.
authors.forename: Wederson M
authors.initials: WM
authors.lastname: Claudino
authors.affiliation: Department of Radiation Oncology, University of Louisville, Louisville, KY, United States.
authors.forename: Mehran
authors.initials: M
authors.lastname: Yusuf
authors.affiliation: Clinical Trials Unit, James Graham Brown Cancer Center, Louisville, KY, United States.
authors.forename: Teresa
authors.initials: T
authors.lastname: Roberts
authors.affiliation: Division of Medical Oncology and Hematology, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, United States.
authors.forename: Dharamvir
authors.initials: D
authors.lastname: Jain
authors.affiliation: Division of Medical Oncology and Hematology, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, United States.
authors.forename: Alfred
authors.initials: A
authors.lastname: Jenson
authors.affiliation: Division of Medical Oncology and Hematology, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, United States.
authors.forename: Sujita
authors.initials: S
authors.lastname: Khanal
authors.affiliation: Department of Radiation Oncology, University of Louisville, Louisville, KY, United States.
authors.forename: Craig I
authors.initials: CI
authors.lastname: Silverman
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery and Communicative Disorders, University of Louisville, Louisville, KY, United States.
authors.forename: Paul
authors.initials: P
authors.lastname: Tennant
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery and Communicative Disorders, University of Louisville, Louisville, KY, United States.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Bumpous
authors.affiliation: Department of Radiation Oncology, University of Louisville, Louisville, KY, United States.
authors.forename: Neal E
authors.initials: NE
authors.lastname: Dunlap
authors.affiliation: Biostatistics Shared Facility, JG Brown Cancer Center, University of Louisville, KY, United States; Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, KY, United States.
authors.forename: Shesh N
authors.initials: SN
authors.lastname: Rai
authors.affiliation: Division of Medical Oncology and Hematology, James Graham Brown Cancer Center, University of Louisville, Louisville, KY, United States.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Redman
mesh_terms: D000328:Adult; D000368:Aged; D052685:Alphapapillomavirus / Q000472:pathogenicity*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000821:virology; D002945:Cisplatin / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000188:drug therapy* / Q000821:virology; D000077195:Squamous Cell Carcinoma of Head and Neck
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin
keywords: Chemoradiotherapy; Cisplatin; Head and neck cancer; Human papillomavirus; Oropharynx; Toxicity