Riassunto analitico
Introduction. During the last few decades, a new major risk factor associated with Oropharyngeal Squamous Cell Carcinoma (OPSCC) has been described. In addition to the traditional risk factors for OPSCC, such as smoking and alcohol consumption, HPV infection plays an important role in the tumor pathogenesis. Despite a better loco-regional control and survival, 10% to 25% of patients with HPV+ OPSCC experience disease progression within 3 years of completing primary therapy. Unlike HPV- cases, in which loco-regional failure still predominates, distant metastasis represents the major reason for failure in HPV+ patients. The aim of this study is to identify whether, in a group of patients with OPSCC treated with chemoradiotherapy or radiotherapy, there are any patient-related or tumor-related factors capable of predicting the response to treatment and to define their oncological outcomes.
Methods. In this monocentric retrospective observational study, we included patients with a diagnosis of OPSCC who were treated with curative intent with chemoradiotherapy or radiotherapy at the Department of Otolaryngology-Head and Neck Surgery, University Hospital of Modena, Italy, between January 2010 and May 2021. The degree of response to treatment was defined based on the RECIST Criteria. We excluded: patients who had already been treated with chemoradiation therapy, patients who didn’t perform imaging 2-3 months after completing the treatment, and patients whose follow-up was not available or was less than 3 years.
Results. we included 223 patients with a mean age at diagnosis of 62 years. There is no statistical difference in OS and DSS between patients who underwent chemoradiotherapy or radiotherapy alone as a primary treatment. We evaluated whether the response to treatment was influenced by age, smoking exposure, oropharynx subsites, p16 status, grading, and tumor stage, and we also analyzed the response after cancer recurrence.
Conclusion. In a period in which the concept of de-escalating the cure is emerging, understanding predictive factors for treatment response could help us stratify patients and address them towards the most effective therapeutic approach from the time of diagnosis.
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