Risk stratification after recurrence of human papillomavirus (HPV)-related and non-HPV-related oropharyngeal cancer: Secondary analysis of NRG Oncology RTOG 0129 and 0522

Elaine O Bigelow; Jonathan Harris; Carole Fakhry; Maura L Gillison; Phuc Felix Nguyen-Tân; David I Rosenthal; Steven J Frank; Suresh G Nair; Houda Bahig; John A Ridge; Jimmy Caudell; Craig Donaldson; Bradley T Clifford; George Shenouda; Michael J Birrer; Yuhchyau Chen; Quynh-Thu Le

doi:10.1002/hed.26915

Risk stratification after recurrence of human papillomavirus (HPV)-related and non-HPV-related oropharyngeal cancer: Secondary analysis of NRG Oncology RTOG 0129 and 0522

Head Neck. 2022 Jan;44(1):158-167. doi: 10.1002/hed.26915. Epub 2021 Nov 3.

Authors

Elaine O Bigelow¹, Jonathan Harris², Carole Fakhry¹, Maura L Gillison³, Phuc Felix Nguyen-Tân⁴, David I Rosenthal³, Steven J Frank³, Suresh G Nair⁵, Houda Bahig⁴, John A Ridge⁶, Jimmy Caudell⁷, Craig Donaldson⁸, Bradley T Clifford⁹, George Shenouda¹⁰, Michael J Birrer¹¹, Yuhchyau Chen¹², Quynh-Thu Le¹³

Affiliations

¹ Department of Otolaryngology - Head & Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
² NRG Oncology Statistics and Data Management Center, American College of Radiology, Philadelphia, Pennsylvania, USA.
³ The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.
⁴ Department of Radiation Oncology, Centre Hospitalier de l'Universite de Montreal, Montreal, Quebec, Canada.
⁵ Department of Hematology and Oncology, Lehigh Valley Hospital, Allentown, Pennsylvania, USA.
⁶ Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania, USA.
⁷ H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.
⁸ Intermountain Medical Center, St. George, Utah, USA.
⁹ Department of Oncology, Summa Health System - Akron Campus, Akron, Ohio, USA.
¹⁰ Department of Radiation Oncology, The Research Institute of the McGill University Health Centre (MUHC), Montreal, Quebec, Canada.
¹¹ Department of Medical Oncology, University of Alabama at Birmingham Cancer Center, Birmingham, Alabama, USA.
¹² Department of Radiation Oncology, University of Rochester, Rochester, New York, USA.
¹³ Department of Radiation Oncology, Stanford University, Stanford, California, USA.

Abstract

Background: No risk-stratification strategies exist for patients with recurrent oropharyngeal cancer (OPC).

Methods: Retrospective analysis using data from prospective NRG Oncology clinical trials RTOG 0129 and 0522. Eligibility criteria included known p16 status and smoking history, and locoregional/distant recurrence. Overall survival (OS) was measured from date of recurrence. Recursive partitioning analysis was performed to produce mutually exclusive risk groups.

Results: Hundred and fifty-four patients were included with median follow-up after recurrence of 3.9 years (range 0.04-9.0). The most important factors influencing survival were p16 status and type of recurrence, followed by surgical salvage and smoking history (≤20 vs. >20 pack-years). Three significantly different risk groups were identified. Patients in the low-, intermediate-, and high-risk groups had 2-year OS after recurrence of 81.1% (95%CI 68.5-93.7), 50.2% (95%CI 36.0-64.5), and 20.8% (95%CI 10.5-31.1), respectively.

Conclusion: Patient and tumor characteristics may be used to stratify patients into risk groups at the time of OPC recurrence.

Keywords: Radiation Therapy Oncology Group; human papillomavirus; recurrent oropharyngeal cancer; recursive partitioning analysis; survival.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Alphapapillomavirus*
Humans
Neoplasm Recurrence, Local / epidemiology
Oropharyngeal Neoplasms* / therapy
Papillomaviridae
Papillomavirus Infections* / complications
Papillomavirus Infections* / epidemiology
Prospective Studies
Retrospective Studies
Risk Assessment

Abstract

Publication types

MeSH terms

Grants and funding