TY - JOUR
T1 - Conditional survival among patients with oropharyngeal cancer treated with radiation therapy and alive without recurrence 5 years after diagnosis
AU - Dahlstrom, Kristina R.
AU - Song, Juhee
AU - Thall, Peter F.
AU - Fuller, Clifton D.
AU - Hutcheson, Katherine A.
AU - Johnson, Faye M.
AU - Gunn, G. Brandon
AU - Phan, Jack
AU - Frank, Steven J.
AU - Morrison, William H.
AU - Ferrarotto, Renata
AU - Rosenthal, David I.
AU - Sturgis, Erich M.
AU - Garden, Adam S.
N1 - Funding Information:
We acknowledge funding contributions from the Christopher and Susan Damico Chair in Viral Associated Malignancies (MD Anderson Cancer Center). This research was conducted within the Oropharynx Program at MD Anderson Cancer Center and funded in part through the Stiefel Oropharyngeal Research Fund. Our work is supported by the National Institutes of Health/National Cancer Institute under award number P30CA016672.
Publisher Copyright:
© 2020 American Cancer Society
PY - 2021/4/15
Y1 - 2021/4/15
N2 - 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.
AB - 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.
KW - conditional survival
KW - head and neck neoplasms
KW - oropharyngeal cancer
KW - radiation therapy
KW - standardized mortality ratios
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U2 - 10.1002/cncr.33370
DO - 10.1002/cncr.33370
M3 - Article
C2 - 33306202
AN - SCOPUS:85097381070
SN - 0008-543X
VL - 127
SP - 1228
EP - 1237
JO - Cancer
JF - Cancer
IS - 8
ER -