Reduced Follow-Up May Be Reasonable for HPV+ Oropharyngeal SCC

Human papillomavirus-positive oropharyngeal squamous cell carcinoma (HPV+ OPSCC) has a low risk of disease recurrence.
Human papillomavirus-positive oropharyngeal squamous cell carcinoma (HPV+ OPSCC) has a low risk of disease recurrence.

Human papillomavirus-positive oropharyngeal squamous cell carcinoma (HPV+ OPSCC) has a low risk of disease recurrence and late toxicity after treatment with approximately two-thirds of events occurring within the first 6 months of follow-up, according to a new study published online ahead of print in the journal Cancer.

Because optimal follow-up can help maximize utilization of health care resources, particularly for the growing number of patients with HPV+ OPSCC, researchers sought to evaluate time to disease recurrence of late toxicity in patients with this disease to optimize patient management.

For the study, researchers analyzed data from 232 patients with biopsy-proven, nonmetastatic HPV+ OPSCC who received radiotherapy. Patients were followed every 3 months for the first year, every 4 months for the second year, and every 6 months for the third through fifth year.

Results showed that the 3-year locoregional control, distant control, and overall survival rates were 94%, 91%, and 91%, respectively.

In regard to safety, late toxicity occurred in 9% of patients. Researchers found that 64% of toxicity and failure events occurred within the first 6 months of follow-up, with a less than 2% event incidence occurring at each subsequent follow-up. Only 4 patients experienced their first adverse events after 2 years of follow-up.

“These data suggest that it may be reasonable to reduce follow-up in patients with HPV+ OPSCC to every 3 months for the first 6 months, every 6 months for the first 2 years, and annually thereafter,” the authors conclude.

REFERENCE

1. Frakes JM, Naghavi AO, Demetriou SK, et al. Determining optimal follow-up in the management of human papillomavirus-positive oropharyngeal cancer [published online ahead of print November 13, 2015]. Cancer. doi:10.1002/cncr.29782.

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