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Title: Prognostic Value of p16 Status on the Development of a Complete Response in Involved Oropharynx Cancer Neck Nodes After Cisplatin-Based Chemoradiation: A Secondary Analysis of NRG Oncology RTOG 0129

Abstract

Purpose: To determine the relationship between p16 status and the regional response of patients with node-positive oropharynx cancer treated on NRG Oncology RTOG 0129. Methods and Materials: Patients with N1-N3 oropharynx cancer and known p16 status who underwent treatment on RTOG 0129 were analyzed. Pathologic complete response (pCR) rates in patients treated with a postchemoradiation neck dissection (with p16-positive or p16-negative cancer) were compared by Fisher exact test. Patients managed expectantly were compared with those treated with a neck dissection. Results: Ninety-nine (34%) of 292 patients with node-positive oropharynx cancer and known p16 status underwent a posttreatment neck dissection (p16-positive: n=69; p16-negative: n=30). The remaining 193 patients with malignant lymphadenopathy at diagnosis were observed. Neck dissection was performed a median of 70 (range, 17-169) days after completion of chemoradiation. Neither the pretreatment nodal stage (P=.71) nor the postradiation, pre-neck dissection clinical/radiographic neck assessment (P=.42) differed by p16 status. A pCR was more common among p16-positive patients (78%) than p16-negative patients (53%, P=.02) and was associated with a reduced incidence of local–regional failure (hazard ratio 0.33, P=.003). On multivariate analysis of local–regional failure, a test for interaction between pCR and p16 status was not significant (P=.37). One-hundred ninety-three (66%) of 292more » of initially node-positive patients were managed without a posttreatment neck dissection. Development of a clinical (cCR) was not significantly influenced by p16-status (P=.42). Observed patients with a clinical nodal CR had disease control outcomes similar to those in patients with a pCR neck dissection. Conclusions: Patients with p16-positive tumors had significantly higher pCR and locoregional control rates than those with p16-negative tumors.« less

Authors:
 [1];  [2];  [3];  [4];  [3];  [5];  [6];  [7];  [1];  [8];  [9]
  1. Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States)
  2. NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania (United States)
  3. Centre Hospitalier de l'Universite de Montreal-Notre Dame, Montréal, Québec (Canada)
  4. University of Texas MD Anderson Cancer Center, Houston, Texas (United States)
  5. L Hotel-Dieu de Quebec, Québec City, Québec (Canada)
  6. The James Brown Cancer Center–University of Louisville, Louisville, Kentucky (United States)
  7. University of California Davis Medical Center, Sacramento, California (United States)
  8. London Regional Cancer Program, London, Ontario (Canada)
  9. Stanford University Medical Center, Stanford, California (United States)
Publication Date:
OSTI Identifier:
22645653
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 96; Journal Issue: 2; Other Information: Copyright (c) 2016 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CHEMOTHERAPY; MULTIVARIATE ANALYSIS; NECK; NEOPLASMS; PATIENTS

Citation Formats

Galloway, Thomas J., E-mail: thomas.galloway@fccc.edu, Zhang, Qiang, Nguyen-Tan, Phuc Felix, Rosenthal, David I., Soulieres, Denis, Fortin, André, Silverman, Craig L., Daly, Megan E., Ridge, John A., Hammond, J. Alexander, and Le, Quynh-Thu. Prognostic Value of p16 Status on the Development of a Complete Response in Involved Oropharynx Cancer Neck Nodes After Cisplatin-Based Chemoradiation: A Secondary Analysis of NRG Oncology RTOG 0129. United States: N. p., 2016. Web. doi:10.1016/J.IJROBP.2016.05.026.
Galloway, Thomas J., E-mail: thomas.galloway@fccc.edu, Zhang, Qiang, Nguyen-Tan, Phuc Felix, Rosenthal, David I., Soulieres, Denis, Fortin, André, Silverman, Craig L., Daly, Megan E., Ridge, John A., Hammond, J. Alexander, & Le, Quynh-Thu. Prognostic Value of p16 Status on the Development of a Complete Response in Involved Oropharynx Cancer Neck Nodes After Cisplatin-Based Chemoradiation: A Secondary Analysis of NRG Oncology RTOG 0129. United States. doi:10.1016/J.IJROBP.2016.05.026.
Galloway, Thomas J., E-mail: thomas.galloway@fccc.edu, Zhang, Qiang, Nguyen-Tan, Phuc Felix, Rosenthal, David I., Soulieres, Denis, Fortin, André, Silverman, Craig L., Daly, Megan E., Ridge, John A., Hammond, J. Alexander, and Le, Quynh-Thu. Sat . "Prognostic Value of p16 Status on the Development of a Complete Response in Involved Oropharynx Cancer Neck Nodes After Cisplatin-Based Chemoradiation: A Secondary Analysis of NRG Oncology RTOG 0129". United States. doi:10.1016/J.IJROBP.2016.05.026.
@article{osti_22645653,
title = {Prognostic Value of p16 Status on the Development of a Complete Response in Involved Oropharynx Cancer Neck Nodes After Cisplatin-Based Chemoradiation: A Secondary Analysis of NRG Oncology RTOG 0129},
author = {Galloway, Thomas J., E-mail: thomas.galloway@fccc.edu and Zhang, Qiang and Nguyen-Tan, Phuc Felix and Rosenthal, David I. and Soulieres, Denis and Fortin, André and Silverman, Craig L. and Daly, Megan E. and Ridge, John A. and Hammond, J. Alexander and Le, Quynh-Thu},
abstractNote = {Purpose: To determine the relationship between p16 status and the regional response of patients with node-positive oropharynx cancer treated on NRG Oncology RTOG 0129. Methods and Materials: Patients with N1-N3 oropharynx cancer and known p16 status who underwent treatment on RTOG 0129 were analyzed. Pathologic complete response (pCR) rates in patients treated with a postchemoradiation neck dissection (with p16-positive or p16-negative cancer) were compared by Fisher exact test. Patients managed expectantly were compared with those treated with a neck dissection. Results: Ninety-nine (34%) of 292 patients with node-positive oropharynx cancer and known p16 status underwent a posttreatment neck dissection (p16-positive: n=69; p16-negative: n=30). The remaining 193 patients with malignant lymphadenopathy at diagnosis were observed. Neck dissection was performed a median of 70 (range, 17-169) days after completion of chemoradiation. Neither the pretreatment nodal stage (P=.71) nor the postradiation, pre-neck dissection clinical/radiographic neck assessment (P=.42) differed by p16 status. A pCR was more common among p16-positive patients (78%) than p16-negative patients (53%, P=.02) and was associated with a reduced incidence of local–regional failure (hazard ratio 0.33, P=.003). On multivariate analysis of local–regional failure, a test for interaction between pCR and p16 status was not significant (P=.37). One-hundred ninety-three (66%) of 292 of initially node-positive patients were managed without a posttreatment neck dissection. Development of a clinical (cCR) was not significantly influenced by p16-status (P=.42). Observed patients with a clinical nodal CR had disease control outcomes similar to those in patients with a pCR neck dissection. Conclusions: Patients with p16-positive tumors had significantly higher pCR and locoregional control rates than those with p16-negative tumors.},
doi = {10.1016/J.IJROBP.2016.05.026},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 2,
volume = 96,
place = {United States},
year = {Sat Oct 01 00:00:00 EDT 2016},
month = {Sat Oct 01 00:00:00 EDT 2016}
}