Patient perspectives and treatment regret after de‐escalated chemoradiation for human papillomavirus‐positive oropharyngeal cancer: Findings from a phase II trial

• Published in: Head & neck 2019-08, Vol.41 (8), p.2768-2776
• Main Authors: Shaverdian, Narek, Hegde, John V., Felix, Carol, Hsu, Sophia, Basehart, Vincent, Steinberg, Michael L., Chen, Allen M.
• Format: Article
• Language: English
• Subjects: Chemoradiotherapy; de‐escalation; Head and neck; Human papillomavirus; Oropharyngeal cancer; Oropharynx; patient perspective; Patients; priorities; Squamous cell carcinoma; Swallowing; Throat cancer
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.25760

Background We evaluated priorities, expectations, and regret among patients treated on a phase II trial of de‐escalated chemoradiation for human papillomavirus (HPV)‐positive oropharyngeal cancer. Methods Eligibility included stage III/IV squamous cell carcinoma of the oropharynx, p16‐positivity, age ≥18 years, and Zubrod score 0‐1. Participants were surveyed with validated measures evaluating their treatment experience. Results Twenty‐four of 27 (89%) patients participated with a median follow‐up of 24 months. Twenty‐three subjects (96%) selected “being cured” or “living as long as possible” as top priority. No patient reported any regret about the decision to enroll on a de‐escalation protocol. Sixteen participants (67%) found retrospectively reported long‐term swallowing function to be either better than or as originally expected. Conclusions These data offer a baseline landscape of perspectives and priorities for patients treated with de‐escalation for HPV‐positive oropharyngeal carcinoma and provide support to the fundamental premise underlying ongoing efforts to establish a new standard of care.