logo

Patterns of Distant Failure and Second Primary Cancers in Patients with Oropharyngeal Squamous Cell Carcinoma: Implications for Surveillance Methodology

Authors

  • Edwin F. Crandley

    Department of Radiation Oncology, University of Virginia, P.O. Box 800383, Charlottesville, VA 22908, USA

  • David D. Wilson

    Department of Radiation Oncology, University of Virginia, P.O. Box 800383, Charlottesville, VA 22908, USA

  • Austin J. Sim

    Department of Radiation Oncology, University of Virginia, P.O. Box 800383, Charlottesville, VA 22908, USA

  • Neil Majithia

    Department of Radiation Oncology, University of Virginia, P.O. Box 800383, Charlottesville, VA 22908, USA

  • Edward B. Stelow

    Department of Pathology, University of Virginia, P.O. Box 800904, Charlottesville, VA 22908, USA

  • Mark J. Jameson

    Department of Otolaryngology – Head and Neck Surgery, University of Virginia, P.O. Box 800713, Charlottesville, VA 22908, USA

  • David C. Shonka Jr.

    Department of Otolaryngology – Head and Neck Surgery, University of Virginia, P.O. Box 800713, Charlottesville, VA 22908, USA

  • Asal S. Rahimi

    Department of Radiation Oncology, University of Texas – Southwestern, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA

  • Paul W. Read

    Department of Radiation Oncology, University of Virginia, P.O. Box 800383, Charlottesville, VA 22908, USA

DOI:

https://doi.org/10.6000/1929-2279.2014.03.03.5

Keywords:

Oropharynx cancer, surveillance, survivorship care, distant metastasis, second primary cancer.

Abstract

 Background: We analyzed the pattern of distant metastasis (DM) and secondary primary cancers (SPC) in patients with oropharyngeal squamous cell carcinoma (OPSCC) to develop surveillance guidelines.

Methods: A retrospective review of 177 patients with OPSCC treated with intensity modulated radiation therapy ± chemotherapy between 2002 and 2012 was performed to characterize the rate, pattern, and timing of DM and SPC.

Results: Sixteen patients (9.0%) developed DM and 9 patients (5.1%) developed a SPC. Overall, 24/177 patients (13.6%) developed a DM and/or SPC for a total of 27 events. 92.6% (25/27) of events were detectable on physical exam and/or chest CT. p16+ patients developed DM later than p16- tumors (23.4 months versus 8.7 months).

Conclusions: Chest CT with physical examination detects the majority of DM and SPC in patients with OPSCC and would provide effective surveillance in these patients. A risk adapted surveillance strategy is proposed.

References

Daly ME, Le QT, Maxim PG, et al. Intensity-modulated radiotherapy in the treatment of oropharyngeal cancer: Clinical outcomes and patterns of failure. Int J Radiat Oncol Biol Phys 2010; 76: 1339-46. http://dx.doi.org/10.1016/j.ijrobp.2009.04.006

Setton J, Caria N, Romanyshyn J, et al. Intensity-modulated radiotherapy in the treatment of oropharyngeal cancer: An update of the memorial sloan-kettering cancer center experience. Int J Radiat Oncol Biol Phys 2012; 82: 291-8. http://dx.doi.org/10.1016/j.ijrobp.2010.10.041

Ang KK, Harris J, Wheeler R, et al. Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med 2010; 363: 24-35. http://dx.doi.org/10.1056/NEJMoa0912217

Shonka DC Jr, Shoushtari AN, Thomas CY, et al. Predicting residual neck disease in patients with oropharyngeal squamous cell carcinoma treated with radiation therapy: Utility of p16 status. Arch Otolaryngol Head Neck Surg 2009; 135: 1126-32. http://dx.doi.org/10.1001/archoto.2009.153

Huang SH, Perez-Ordonez B, Weinreb I, et al. Natural course of distant metastases following radiotherapy or chemoradiotherapy in HPV-related oropharyngeal cancer. Oral Oncol 2013; 49: 79-85. http://dx.doi.org/10.1016/j.oraloncology.2012.07.015

Huang SH, Perez-Ordonez B, Liu FF, et al. Atypical clinical behavior of p16-confirmed HPV-related oropharyngeal squamous cell carcinoma treated with radical radiotherapy. Int J Radiat Oncol Biol Phys 2012; 82: 276-83. http://dx.doi.org/10.1016/j.ijrobp.2010.08.031

Blanchard P, Baujat B, Holostenco V, et al. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): A comprehensive analysis by tumour site. Radiother Oncol 2011; 100: 33-40. http://dx.doi.org/10.1016/j.radonc.2011.05.036

Denis F, Garaud P, Bardet E, et al. Final results of the 94-01 french head and neck oncology and radiotherapy group randomized trial comparing radiotherapy alone with concomitant radiochemotherapy in advanced-stage oropharynx carcinoma. J Clin Oncol 2004; 22: 69-76. http://dx.doi.org/10.1200/JCO.2004.08.021

Reimers N, Kasper HU, Weissenborn SJ, et al. Combined analysis of HPV-DNA, p16 and EGFR expression to predict prognosis in oropharyngeal cancer. Int J Cancer 2007; 120: 1731-8. http://dx.doi.org/10.1002/ijc.22355

de Bree R, Deurloo EE, Snow GB, Leemans CR. Screening for distant metastases in patients with head and neck cancer. Laryngoscope 2000; 110(Pt 1): 397-401. http://dx.doi.org/10.1097/00005537-200003000-00012

Spector ME, Chinn SB, Rosko AJ, et al. Diagnostic modalities for distant metastasis in head and neck squamous cell carcinoma: Are we changing life expectancy? Laryngoscope 2012; 122: 1507-11. http://dx.doi.org/10.1002/lary.23264

National Lung Screening Trial Research Team, Aberle DR, Adams AM, Berg CD, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med 2011; 365: 395-409. http://dx.doi.org/10.1056/NEJMoa1102873

O'Sullivan B, Huang SH, Siu LL, et al. Deintensification candidate subgroups in human papillomavirus-related oropharyngeal cancer according to minimal risk of distant metastasis. J Clin Oncol 2013; 31: 543-50. http://dx.doi.org/10.1200/JCO.2012.44.0164

Riaz N, Setton J, Tam M, et al. Recursive partition analysis identifies oropharyngeal cancer patients at high risk for distant metastasis. Int J Radiat Oncol Biol Phys 2012; 84: S482.

Head and neck cancer clinical practice guidelines version 2.2013

Lung cancer screening clinical practice guidelines version 1.2014

Downloads

Published

2014-07-29

Issue

Vol. 3 No. 3 (2014)

Section

Articles

How to Cite

Patterns of Distant Failure and Second Primary Cancers in Patients with Oropharyngeal Squamous Cell Carcinoma: Implications for Surveillance Methodology. (2014). Journal of Cancer Research Updates, 3(3),  151-161. https://doi.org/10.6000/1929-2279.2014.03.03.5

Similar Articles

151-160 of 195

You may also start an advanced similarity search for this article.