Association of follow-up imaging frequency with temporal incidence and patterns of distant failure following (chemo) radiotherapy for HPV related oropharyngeal cancer
Copyright © 2023 Elsevier Ltd. All rights reserved..
OBJECTIVES: Emerging data supports radical intent therapy for oligometastatic (OM) relapsed human papilloma virus (HPV+) related oropharyngeal cancer (OPC). We assess the association of follow-up imaging frequency amongst HPV + OPC, with temporal and spatial patterns of distant relapse, to inform rationalisation of routine post-treatment imaging.
MATERIALS AND METHODS: A retrospective single centre cohort study was carried out of consecutive HPV + OPC patients treated with radical intent (chemo)radiotherapy ((CT)RT) between 2011 and 2019. OM state was defined as ≤ 5 metastasis, none larger than 3 cm (OMs) or, if interval from last negative surveillance imaging > 6-months, then ≤ 10 metastasis, none larger than 5 cm, (OMp). Patients not meeting OMs / OMp criteria were deemed to have incurable diffuse metastatic disease (DMdiffuse).
RESULTS: 793 HPV-OPC patients were identified with median follow-up 3.15years (range 0.2-8.9). 52 (6.6 %) patients had radiologically identified DM at first failure and were considered for analysis. The median time to recurrence was 15.1 months (range: 2.6-63 months). 87 % of distant metastasis (DM) occurred in the first two years after treatment. Twenty-seven (52 %) patients had OM (OMs or OMp) at time of failure, with 31 % having OMs. The median time from completion of treatment to diagnosis of DMdiffuse vs OM was 22.2 months (range: 2.6-63.1 months) vs 11.6 months (range: 3.5-32.5 months). The probability of being diagnosed with OM vs DMdiffuse increased with reducing interval from last negative surveillance scan to imaging identifying DM (≤6 months 88.9 %, 7-12 months 71.4 %, 13-24 months 35 %, > 24 months 22.2 %).
CONCLUSION: We demonstrate that a reduced interval between last negative imaging and subsequent radiological diagnosis of DM is associated with increased likelihood of identification of OM disease. Consideration of increased frequency of surveillance imaging during the first two years of follow up is supported, particularly for patients at high risk of distant failure.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 2023 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:148 |
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| Enthalten in: |
Oral oncology - 148(2023) vom: 21. Jan., Seite 106645 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Gaffney, John [VerfasserIn] |
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| Links: |
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| Themen: |
Head and neck |
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| Anmerkungen: |
Date Completed 25.12.2023 Date Revised 25.12.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.oraloncology.2023.106645 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM364837586 |
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| 245 | 1 | 0 | |a Association of follow-up imaging frequency with temporal incidence and patterns of distant failure following (chemo) radiotherapy for HPV related oropharyngeal cancer |
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| 500 | |a Date Completed 25.12.2023 | ||
| 500 | |a Date Revised 25.12.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Ltd. All rights reserved. | ||
| 520 | |a OBJECTIVES: Emerging data supports radical intent therapy for oligometastatic (OM) relapsed human papilloma virus (HPV+) related oropharyngeal cancer (OPC). We assess the association of follow-up imaging frequency amongst HPV + OPC, with temporal and spatial patterns of distant relapse, to inform rationalisation of routine post-treatment imaging | ||
| 520 | |a MATERIALS AND METHODS: A retrospective single centre cohort study was carried out of consecutive HPV + OPC patients treated with radical intent (chemo)radiotherapy ((CT)RT) between 2011 and 2019. OM state was defined as ≤ 5 metastasis, none larger than 3 cm (OMs) or, if interval from last negative surveillance imaging > 6-months, then ≤ 10 metastasis, none larger than 5 cm, (OMp). Patients not meeting OMs / OMp criteria were deemed to have incurable diffuse metastatic disease (DMdiffuse) | ||
| 520 | |a RESULTS: 793 HPV-OPC patients were identified with median follow-up 3.15years (range 0.2-8.9). 52 (6.6 %) patients had radiologically identified DM at first failure and were considered for analysis. The median time to recurrence was 15.1 months (range: 2.6-63 months). 87 % of distant metastasis (DM) occurred in the first two years after treatment. Twenty-seven (52 %) patients had OM (OMs or OMp) at time of failure, with 31 % having OMs. The median time from completion of treatment to diagnosis of DMdiffuse vs OM was 22.2 months (range: 2.6-63.1 months) vs 11.6 months (range: 3.5-32.5 months). The probability of being diagnosed with OM vs DMdiffuse increased with reducing interval from last negative surveillance scan to imaging identifying DM (≤6 months 88.9 %, 7-12 months 71.4 %, 13-24 months 35 %, > 24 months 22.2 %) | ||
| 520 | |a CONCLUSION: We demonstrate that a reduced interval between last negative imaging and subsequent radiological diagnosis of DM is associated with increased likelihood of identification of OM disease. Consideration of increased frequency of surveillance imaging during the first two years of follow up is supported, particularly for patients at high risk of distant failure | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Head and neck | |
| 650 | 4 | |a Human papillomavirus viruses | |
| 650 | 4 | |a Humans | |
| 650 | 4 | |a Incidence | |
| 650 | 4 | |a Metastasis | |
| 650 | 4 | |a Oropharyngeal cancer | |
| 650 | 4 | |a Radiology | |
| 650 | 4 | |a Recurrence | |
| 650 | 4 | |a Squamous cell carcinoma | |
| 650 | 4 | |a Stereotactic body radiotherapy | |
| 700 | 1 | |a Ramzan, Amaila |e verfasserin |4 aut | |
| 700 | 1 | |a Dinizulu, Teresa |e verfasserin |4 aut | |
| 700 | 1 | |a Maley, Cliona |e verfasserin |4 aut | |
| 700 | 1 | |a Onamusi, Oluwasikemi |e verfasserin |4 aut | |
| 700 | 1 | |a Motamedi-Ghahfarokhi, Golnoosh |e verfasserin |4 aut | |
| 700 | 1 | |a Price, Gareth |e verfasserin |4 aut | |
| 700 | 1 | |a Metcalf, Robert |e verfasserin |4 aut | |
| 700 | 1 | |a Garcez, Kate |e verfasserin |4 aut | |
| 700 | 1 | |a Hughes, Christopher |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Lip |e verfasserin |4 aut | |
| 700 | 1 | |a Thomson, David |e verfasserin |4 aut | |
| 700 | 1 | |a Price, James |e verfasserin |4 aut | |
| 700 | 1 | |a Jain, Yatin |e verfasserin |4 aut | |
| 700 | 1 | |a McPartlin, Andrew |e verfasserin |4 aut | |
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