University of Carolina Lineberger Comprehensive Cancer Center researchers have uncovered that by reducing the intensity levels of radiation during treatment for human papillomavirus-associated (HPV)-linked head and neck cancer, results generated 2-year progression-free survival rate couple with less side effects.
Recently reported in Journal of Clinical Oncology, the results generated from a Phase II clinical trial involving 114 patients with HPV-linked head and neck cancer (limited smoking history). When compared to standard of care (e.g. intensity levels involved with previous studies), the de-intensification involving a reduction in radiation and chemotherapy looks to work better than the standard seven-week regimen, reported Bhishamjit S. Chera, MD, UNC Lineberger.
During the study, the patients were given a reduced amount of radiation therapy (60 Gray) and lower dose of chemotherapy (cisplatin) over a six week period. As compared to the standard of care (seven week and 70 Gray treatment and high-dose chemotherapy), the results were better in this UNC study.
The long-term side effects of radiation treatment are problematic and range from swallowing problems to dry mouth. Consequently, patients often require a feeding tube post treatment while some patients report material long-term swallowing problems. In this latest de-intensified study, swallowing problems were less severe and only 34% of the patients required a feeding tube.
The results of this study were perhaps surprising for some and encouraging for at least patients with a limited smoking history. Larger validated randomized clinical trials will be needed to validate these findings. A key moving forward is to identify additional biomarkers to support ongoing advancement of precision treatment approaches.
Bhishamjit S. Chera, MD, associate professor, UNC School of Medicine Department of Radiation Oncology
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