TABLE 3.
Three year Outcomes of HPV+ Oropharyngeal Squamous Cell Carcinoma and HPV– Head and Neck Squamous Cell Carcinoma
| Subgroup by TNM‐7 | Treatment Regimen | Cases, No. | LRC, % (95% CI) | DC, % (95% CI) | Grade 3/4 LT, % (95% CI) |
|---|---|---|---|---|---|
| HPV+ oropharyngeal squamous cell carcinoma | |||||
| T1‐T2N0 | CCRT | 0 | NA | NA | NA |
| RT‐hypo | 15 | 100 | 93 (52‐99) | 0 | |
| RT‐acc | 24 | 100 | 96 (69‐99) | 6 (1‐39) | |
| P | 39 | .524 | .757 | .428 | |
| T1‐T2N1‐N2a | CCRT | 36 | 94 (78‐99) | 94 (78‐99) | 8 (3‐25) |
| RT‐hypo | 18 | 94 (61‐99) | 94 (60‐99) | 0 | |
| RT‐acc | 48 | 100 | 100 | 2 (0‐17) | |
| P | 102 | .769 | .272 | .034 | |
| T1‐2N0‐2a | CCRT | 36 | 94 (78‐99) | 94 (78‐99) | 8 (3‐25) |
| RT‐hypo | 33 | 97 (78‐100) | 94 (76‐98) | 0 | |
| RT‐acc | 72 | 100 | 99 (90‐100) | 4 (1‐15) | |
| P | 141 | .527 | .742 | .015 | |
| T1‐2N2b | CCRT | 227 | 97 (94‐99) | 95 (91‐97) | 12 (8‐18) |
| RT‐hypo | 10 | 90 (29‐99) | 100 | 34 (12‐96) | |
| RT‐acc | 74 | 94 (84‐98) | 96 (87‐99) | 14 (7‐26) | |
| P | 311 | .445 | .697 | .056 | |
| T1‐2N2c/T3N0‐2c | CCRT | 241 | 95 (92‐97) | 87 (82‐91) | 16 (12‐21) |
| RT‐hypo | 9 | 89 (20‐98) | 89 (20‐98) | 11 (1‐92) | |
| RT‐acc | 62 | 93 (82‐97) | 90 (78‐95) | 14 (7‐28) | |
| P | 312 | .494 | .838 | .622 | |
| T4 or N3 | CCRT | 175 | 88 (82‐92) | 87 (80‐91) | 24 (18‐31) |
| RT‐hypo | 9 | 78 (16‐94) | 67 (7‐88) | 14 (2‐101) | |
| RT‐acc | 46 | 84 (68‐92) | 65 (46‐77) | 17 (9‐34) | |
| P | 230 | .677 | .005 | .510 | |
| HPV– head and neck squamous cell carcinoma | |||||
| Stage I/II | CCRT | 2 a | 100 | 100 | 0 |
| RT‐hypo | 179 | 85 (79‐90) | 99 (96‐100) | 5 (2‐9) | |
| RT‐acc | 209 | 89 (84‐93) | 98 (94‐99) | 6 (3‐10) | |
| P | 390 | .320 | .446 | .891 | |
| Stage III | CCRT | 48 | 91 (76‐96) | 90 (76‐95) | 20 (11‐36) |
| RT‐hypo | 39 | 76 (58‐87) | 92 (77‐97) | 3 (0‐20) | |
| RT‐acc | 98 | 69 (58‐77) | 85 (76‐91) | 9 (5‐17) | |
| P | 185 | .006 | .410 | .031 | |
| Stage IV | CCRT | 281 | 73 (68‐78) | 77 (71‐81) | 21 (17‐27) |
| RT‐hypo | 45 | 65 (46‐77) | 82 (66‐90) | 3 (0‐22) | |
| RT‐acc | 144 | 66 (57‐73) | 75 (66‐81) | 20 (14‐28) | |
| P | 470 | .336 | .715 | .008 | |
| HPV– oropharyngeal squamous cell carcinoma | |||||
| Stage I/II/III | CCRT | 14 | 85 (43‐96) | 93 (49‐99) | 29 (12‐68) |
| RT‐hypo | 42 | 88 (72‐95) | 100 | 5 (1‐21) | |
| RT‐acc | 38 | 87 (70‐94) | 97 (80‐100) | 8 (3‐24) | |
| P | 94 | .946 | .254 | .102 | |
| Stage IV | CCRT | 125 | 76 (67‐83) | 80 (72‐86) | 29 (21‐38) |
| RT‐hypo | 17 | 57 (21‐76) | 76 (43‐90) | 7 (1‐63) | |
| RT‐acc | 72 | 62 (49‐72) | 76 (63‐84) | 13 (7‐26) | |
| P | 147 | .100 | .655 | .058 | |
| HPV– laryngeal squamous cell carcinoma | |||||
| Stage I/II | CCRT | 2 a | 100 | 100 | 0 |
| RT‐hypo | 141 | 83 (76‐89) | 99 (95‐100) | 4 (2‐10) | |
| RT‐acc | 194 | 89 (83‐93) | 98 (94‐99) | 5 (3‐10) | |
| P | 337 | .146 | .542 | .792 | |
| Stage III | CCRT | 28 | 92 (69‐98) | 89 (68‐96) | 12 (4‐35) |
| RT‐hypo | 26 | 80 (55‐91) | 88 (66‐96) | 4 (1‐31) | |
| RT‐acc | 67 | 62 (47‐72) | 81 (68‐89) | 10 (5‐21) | |
| P | 121 | .004 | .444 | .413 | |
| Stage IV | CCRT | 86 | 71 (60‐80) | 77 (66‐85) | 12 (7‐22) |
| RT‐hypo | 18 | 71 (37‐87) | 82 (49‐94) | 0 | |
| RT‐acc | 40 | 74 (54‐85) | 78 (59‐88) | 15 (6‐33) | |
| P | 144 | .886 | .982 | .279 | |
| HPV– hypopharyngeal squamous cell carcinoma | |||||
| Stage I/II/III | CCRT | 6 | 100 | 83 0‐98) | 33 (10‐100) |
| RT‐hypo | 9 | 75 (7‐93) | 100 | 0 | |
| RT‐acc | 8 | 75 (9‐93) | 88 (11‐98) | 12 (2‐93) | |
| P | 23 | .424 | .545 | .187 | |
| Stage IV | CCRT | 70 | 71 (58‐80) | 71 (58‐80) | 19 (11‐32) |
| RT‐hypo | 10 | 70 (18‐89) | 90 (28‐99) | 0 | |
| RT‐acc | 32 | 66 (42‐80) | 67 (44‐81) | 40 (25‐65) | |
| P | 112 | .962 | .325 | .022 |
Abbreviations: CCRT, concurrent chemoradiotherapy;DC, distant control; HPV, human papillomavirus; LRC, locoregional control; LT, late toxicity; NA, not applicable; RT‐acc, moderately accelerated radiotherapy; RT‐hypo, hypofractionated radiotherapy; TNM‐7, seventh edition of the TNM system. Bold values denote statistical significance at the p <0.05 level.
a
The 2 stage II cases were T2N0 glottic squamous cell carcinoma with a bulky primary and suspicious T3 disease (suspicious thyroid cartilage invasion on computed tomography). Hence, these were treated as T3 tumors with CCRT.