Hearing Outcomes in a Deintensification Trial of Adjuvant Therapy for HPV-Related Oropharyngeal Squamous Cell Carcinoma
© 2023 American Academy of Otolaryngology-Head and Neck Surgery Foundation..
OBJECTIVE: To explore whether deintensification of adjuvant therapy reduces ototoxicity among patients with human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC).
STUDY DESIGN: Retrospective cohort study.
SETTING: Single academic center.
METHODS: The ototoxicity rate among adult patients with HPV-related OPSCC enrolled in the Minimalist Trial (MINT), a prospective phase 2 trial of surgery followed by risk-adjusted deintensified adjuvant therapy (42 Gy radiation given alone or with a single 100 mg/m2 dose of cisplatin), was compared to that among a historical cohort treated with standard adjuvant therapy (60-66 Gy radiation with up to three 100 mg/m2 doses of cisplatin). Ototoxicity was defined as Common Terminology Criteria for Adverse Events v5.0 ≥ Grade 2. Mixed model analysis was performed to investigate the association between deintensified adjuvant therapy and treatment-related hearing loss.
RESULTS: A total of 29 patients (58 ears) were analyzed in the MINT cohort, and 27 patients (54 ears) in the historical cohort. The ototoxicity rate was 5% (n = 3/58 ears) in the MINT cohort and 46% (n = 25/54 ears) in the historical cohort (difference, 41%; 95% confidence interval [CI] = 27%-56%). Patients in the MINT cohort demonstrated a 95% decrease in risk of ototoxicity compared to those in the historical cohort (adjusted odds ratio: 0.05, 95% CI = 0.01-0.31). Differences in estimated marginal mean threshold shifts were statistically and clinically significant at frequencies ≥ 3 kHz.
CONCLUSION: The deintensified adjuvant therapy given in MINT led to less ototoxicity than standard adjuvant therapy among patients with HPV-related OPSCC.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:168 |
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| Enthalten in: |
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery - 168(2023), 5 vom: 02. Mai, Seite 1089-1096 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Lee, David S [VerfasserIn] |
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| Links: |
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| Themen: |
Cisplatin |
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| Anmerkungen: |
Date Completed 24.04.2023 Date Revised 28.04.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1002/ohn.182 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM354447769 |
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| 100 | 1 | |a Lee, David S |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Hearing Outcomes in a Deintensification Trial of Adjuvant Therapy for HPV-Related Oropharyngeal Squamous Cell Carcinoma |
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| 500 | |a Date Revised 28.04.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 American Academy of Otolaryngology-Head and Neck Surgery Foundation. | ||
| 520 | |a OBJECTIVE: To explore whether deintensification of adjuvant therapy reduces ototoxicity among patients with human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) | ||
| 520 | |a STUDY DESIGN: Retrospective cohort study | ||
| 520 | |a SETTING: Single academic center | ||
| 520 | |a METHODS: The ototoxicity rate among adult patients with HPV-related OPSCC enrolled in the Minimalist Trial (MINT), a prospective phase 2 trial of surgery followed by risk-adjusted deintensified adjuvant therapy (42 Gy radiation given alone or with a single 100 mg/m2 dose of cisplatin), was compared to that among a historical cohort treated with standard adjuvant therapy (60-66 Gy radiation with up to three 100 mg/m2 doses of cisplatin). Ototoxicity was defined as Common Terminology Criteria for Adverse Events v5.0 ≥ Grade 2. Mixed model analysis was performed to investigate the association between deintensified adjuvant therapy and treatment-related hearing loss | ||
| 520 | |a RESULTS: A total of 29 patients (58 ears) were analyzed in the MINT cohort, and 27 patients (54 ears) in the historical cohort. The ototoxicity rate was 5% (n = 3/58 ears) in the MINT cohort and 46% (n = 25/54 ears) in the historical cohort (difference, 41%; 95% confidence interval [CI] = 27%-56%). Patients in the MINT cohort demonstrated a 95% decrease in risk of ototoxicity compared to those in the historical cohort (adjusted odds ratio: 0.05, 95% CI = 0.01-0.31). Differences in estimated marginal mean threshold shifts were statistically and clinically significant at frequencies ≥ 3 kHz | ||
| 520 | |a CONCLUSION: The deintensified adjuvant therapy given in MINT led to less ototoxicity than standard adjuvant therapy among patients with HPV-related OPSCC | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a HPV-related oropharyngeal squamous cell carcinoma | |
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| 650 | 4 | |a hearing outcomes | |
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| 700 | 1 | |a Tharakan, Theresa |e verfasserin |4 aut | |
| 700 | 1 | |a Cathryn Collopy |e verfasserin |4 aut | |
| 700 | 1 | |a Kallogjeri, Dorina |e verfasserin |4 aut | |
| 700 | 1 | |a Thorstad, Wade L |e verfasserin |4 aut | |
| 700 | 1 | |a Adkins, Douglas R |e verfasserin |4 aut | |
| 700 | 1 | |a Oppelt, Peter |e verfasserin |4 aut | |
| 700 | 1 | |a Ley, Jessica |e verfasserin |4 aut | |
| 700 | 1 | |a Wick, Cameron C |e verfasserin |4 aut | |
| 700 | 1 | |a Zevallos, Jose |e verfasserin |4 aut | |
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