Conditional survival among patients with oropharyngeal cancer treated with radiation therapy and alive without recurrence 5 years after diagnosis.
Age Factors
Aged
Bayes Theorem
Cancer Survivors
Cause of Death
Ex-Smokers
Female
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Neoplasm Recurrence, Local
Oropharyngeal Neoplasms
/ mortality
Radiotherapy Dosage
Radiotherapy, Intensity-Modulated
Retrospective Studies
Smokers
Time Factors
Tongue Neoplasms
/ mortality
conditional survival
head and neck neoplasms
oropharyngeal cancer
radiation therapy
standardized mortality ratios
Journal
Cancer
ISSN: 1097-0142
Titre abrégé: Cancer
Pays: United States
ID NLM: 0374236
Informations de publication
Date de publication:
15 04 2021
15 04 2021
Historique:
revised:
27
10
2020
received:
03
06
2020
accepted:
02
11
2020
pubmed:
12
12
2020
medline:
12
11
2021
entrez:
11
12
2020
Statut:
ppublish
Résumé
Risk of recurrence among patients with oropharyngeal cancer (OPC) who survive 5 years is low. The goal of this study was to assess long-term survival of patients with OPC alive without recurrence 5 years after diagnosis. This study included newly diagnosed patients with OPC, who had been treated with radiation and were alive without recurrence 5 years after diagnosis. Overall survival (OS) probabilities beyond 5 years were estimated using the Kaplan-Meier method. Factors associated with OS were determined using Bayesian piecewise exponential survival regression. Standardized mortality ratios for all-cause death were estimated controlling for study year, age, and sex in the US general population. Among 1699 patients, the additional 2-year, 5-year, and 10-year OS probabilities were 94%, 83%, and 63%, respectively, and were lower than those in the general population. Patients who were older, were current or former smokers, had other than tonsil or base of tongue tumors, or had T4 tumors had a higher risk of death. Patients who had base of tongue tumors and had received intensity-modulated radiation therapy (IMRT) or lower-radiation doses had a lower risk of death. Standardized mortality ratios were higher among current and heavy smokers and lower among recipients of IMRT and lower radiation doses. In this large cohort, long-term survival among patients with OPC was good but lower than predicted for the general population. Patients treated with IMRT and those with less tobacco exposure had better outcomes.
Sections du résumé
BACKGROUND
Risk of recurrence among patients with oropharyngeal cancer (OPC) who survive 5 years is low. The goal of this study was to assess long-term survival of patients with OPC alive without recurrence 5 years after diagnosis.
METHODS
This study included newly diagnosed patients with OPC, who had been treated with radiation and were alive without recurrence 5 years after diagnosis. Overall survival (OS) probabilities beyond 5 years were estimated using the Kaplan-Meier method. Factors associated with OS were determined using Bayesian piecewise exponential survival regression. Standardized mortality ratios for all-cause death were estimated controlling for study year, age, and sex in the US general population.
RESULTS
Among 1699 patients, the additional 2-year, 5-year, and 10-year OS probabilities were 94%, 83%, and 63%, respectively, and were lower than those in the general population. Patients who were older, were current or former smokers, had other than tonsil or base of tongue tumors, or had T4 tumors had a higher risk of death. Patients who had base of tongue tumors and had received intensity-modulated radiation therapy (IMRT) or lower-radiation doses had a lower risk of death. Standardized mortality ratios were higher among current and heavy smokers and lower among recipients of IMRT and lower radiation doses.
CONCLUSIONS
In this large cohort, long-term survival among patients with OPC was good but lower than predicted for the general population. Patients treated with IMRT and those with less tobacco exposure had better outcomes.
Identifiants
pubmed: 33306202
doi: 10.1002/cncr.33370
pmc: PMC8058232
mid: NIHMS1662865
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1228-1237Subventions
Organisme : NCI NIH HHS
ID : P30 CA016672
Pays : United States
Organisme : Christopher and Susan Damico Chair in Viral Associated Malignancies
Organisme : Stiefel Oropharyngeal Research Fund
Informations de copyright
© 2020 American Cancer Society.
Références
Head Neck. 2017 Oct;39(10):2135-2141
pubmed: 28675547
JAMA Otolaryngol Head Neck Surg. 2018 Nov 1;144(11):1066-1076
pubmed: 30193299
Head Neck. 2019 Nov;41(11):3880-3894
pubmed: 31441572
Semin Radiat Oncol. 2012 Apr;22(2):128-42
pubmed: 22385920
J Clin Oncol. 2013 Mar 1;31(7):845-52
pubmed: 23182993
Int J Radiat Oncol Biol Phys. 2016 Nov 1;96(3):589-96
pubmed: 27681754
Int J Radiat Oncol Biol Phys. 2017 Mar 15;97(4):678-686
pubmed: 27209505
Clin Cancer Res. 2015 Apr 1;21(7):1530-6
pubmed: 25833308
J Natl Cancer Inst. 2008 Feb 20;100(4):261-9
pubmed: 18270337
Int J Radiat Oncol Biol Phys. 2017 Mar 15;97(4):700-708
pubmed: 27485284
Oral Oncol. 2019 Aug;95:59-64
pubmed: 31345395
Cancer. 2012 Dec 1;118(23):5793-9
pubmed: 23640737
Radiother Oncol. 2009 Jul;92(1):4-14
pubmed: 19446902
Lancet. 2019 Jan 5;393(10166):40-50
pubmed: 30449625
MMWR Morb Mortal Wkly Rep. 2016 Nov 11;65(44):1205-1211
pubmed: 27832052
J Clin Oncol. 2015 May 20;33(15):1707-8
pubmed: 25823739
Head Neck. 2017 Aug;39(8):1516-1523
pubmed: 28452175
J Natl Cancer Inst. 2003 Oct 1;95(19):1434-9
pubmed: 14519749
Cancer. 2017 Jan 1;123(2):283-293
pubmed: 27662641
Cancer. 2014 Mar 1;120(5):702-10
pubmed: 24421077
Int J Radiat Oncol Biol Phys. 2014 May 1;89(1):13-20
pubmed: 24613816
N Engl J Med. 2010 Jul 1;363(1):24-35
pubmed: 20530316
Int J Radiat Oncol Biol Phys. 2017 Mar 15;97(4):687-699
pubmed: 27727066
J Clin Oncol. 2014 Oct 20;32(30):3365-73
pubmed: 24958820
Clin Transl Radiat Oncol. 2019 Jun 15;18:16-22
pubmed: 31341972
Stroke. 2011 Sep;42(9):2410-8
pubmed: 21817150
J Clin Oncol. 2008 Nov 1;26(31):5119-25
pubmed: 18725647
Eur J Cancer. 2016 Sep;64:1-11
pubmed: 27323346