Patients diagnosed with human papillomavirus (HPV)-positive head and neck cancers could be treated with a lower-dose of intensity-modulated radiation therapy, reducing the risks of side effects, according to a new study.
The study, led by researchers at Vanderbilt-Ingram Cancer Center in Nashville, Tennessee, was highlighted at the 2014 Annual Meeting of the American Society of Clinical Oncology in Chicago.
The phase II study included 90 patients with stage III and IV HPV-positive oropharyngeal squamous carcinoma who received induction chemotherapy with paclitaxel, cisplatin and cetuximab.
Researchers focused on both clinical outcomes as well as long-term side effects.
City of Hope’s Sagus Sampath, M.D., assistant clinical professor in the Department of Radiation Oncology, helped enroll patients in the ECOG 1308 trial while at the University of New Mexico. He found the results to be an exciting step forward in the goal of reducing treatment intensity for HPV-positive oropharynx squamous cell cancers.
“These results show for the first time that a reduced dose of radiation is associated with high rates of local-regional disease control in the setting of ‘clinical complete response’ [cCR] following induction chemotherapy,” Sampath said. “This also points to the potential reliability of an endoscopic assessment of clinical response following induction chemotherapy.”
However, while the study’s results show great progress, more work still needs to be done before the practice can be widely accepted, Sampath noted.
"What is unknown is whether with longer follow-up these excellent control rates will be maintained,” Sampath said. “A similar trial design in the definitive chemoradiotherapy setting will be necessary before implementing reduced radiation dose as a standard-of-care practice."
The abstract (#LBA6006) is available on ASCO's website.
Learn more about head and neck cancer treatment at City of Hope.