Evidence map›Paper›PMID 28434660›Full record

Trial reportThe Lancet. Oncology2017

Reduced-dose radiotherapy for human papillomavirus-associated squamous-cell carcinoma of the oropharynx: a single-arm, phase 2 study.

Allen M Chen, Carol Felix, Pin-Chieh Wang, Sophia Hsu, Vincent Basehart, Jordan Garst, Phillip Beron, Deborah Wong, Michael H Rosove, Shyam Rao and 8 more

2 registry-linked trialsOpen access · greenAbstract readClinical Trial, Phase II
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The Lancet. Oncology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 158 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
158citing papers in PubMed, 4 pooled it
35.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03729518 nacompletednot on this mapstarted 2018, after this paper: background citation

A Phase II Study of Volume and Dose De-Intensification Following Transoral Robotic Surgery (TORS) and Neck Dissection for p16+ Oropharyngeal Squamous Cell Carcinoma

TypeinterventionalSponsorAbramson Cancer Center at Penn MedicineRan2018 to 2026Enrolled150ConditionsOropharyngeal Cancer, Squamous Cell Carcinoma, Human Papilloma VirusArmsRadiation Therapy (IMRT or IMPT)
NCT06313450 narecruitingnot on this mapstarted 2024, after this paper: background citation

De-escalated Radiotherapy for Primary Tumor After Neoadjuvant Therapy With Toripalimab Plus Chemotherapy for Nasopharyngeal Carcinoma

TypeinterventionalSponsorSun Yat-sen UniversityRan2024 to 2028Enrolled112ConditionsNasopharyngeal Carcinoma, Radiotherapy, Complications, IMMUNOTHERAPYArmsde-escalated radiotherapy, conventional radiotherapy
3 · Its place in the literature

Who cites it

158 citing papers in PubMed, 4 syntheses or guidelines pooled it, 324 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Upfront Neck Dissection for Treatment Selection and Improvement in Quality of Life as a Novel Treatment Paradigm for Deintensification in HPV+ OPSCC.Clinical cancer research : an official journal of the American Association for Cancer Research · 2024
    Trial
  7. Hypoxia-Directed Treatment of Human Papillomavirus-Related Oropharyngeal Carcinoma.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024
    Trial
  8. Trial
  9. Initial Feasibility and Acute Toxicity Outcomes From a Phase 2 Trial ofInternational journal of radiation oncology, biology, physics · 2023
    Trial
  10. Trial
  11. Trial
  12. Trial
  13. Reduced-Dose Radiation Therapy for HPV-Associated Oropharyngeal Carcinoma (NRG Oncology HN002).Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2021
    Trial
  14. Trial
  15. Phase II Trial of De-Intensified Chemoradiotherapy for Human Papillomavirus-Associated Oropharyngeal Squamous Cell Carcinoma.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2019
    Trial
  16. Trial
  17. Trial
  18. Article
  19. Article
  20. Review

98 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

18 authors at 2 institutions in 1 country.

Allen M ChenDepartment of Radiation Oncology, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, USA. Electronic address: achen5@kumc.edu.
Carol FelixDepartment of Radiation Oncology, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, USA.
Pin-Chieh WangDepartment of Radiation Oncology, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, USA.
Sophia HsuDepartment of Radiation Oncology, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, USA.
Vincent BasehartDepartment of Radiation Oncology, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, USA.
Jordan GarstDepartment of Radiation Oncology, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, USA.
Phillip BeronDepartment of Radiation Oncology, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, USA.
Deborah WongDepartment of Internal Medicine, Division of Hematology and Oncology, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, USA.
Michael H RosoveDepartment of Internal Medicine, Division of Hematology and Oncology, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, USA.
Shyam RaoDepartment of Radiation Oncology, University of California, Davis, School of Medicine, Sacramento, CA, USA.
Heather MelansonDepartment of Radiation Oncology, University of California, Davis, School of Medicine, Sacramento, CA, USA.
Edward KimDepartment of Internal Medicine, Division of Hematology and Oncology, University of California, Davis, School of Medicine, Sacramento, CA, USA.
Daphne PalmerDepartment of Radiation Oncology, University of California, Davis, School of Medicine, Sacramento, CA, USA.
Lihong QiDepartment of Public Health Sciences, Division of Biostatistics, University of California, Davis, School of Medicine, Sacramento, CA, USA.
Karen KellyDepartment of Internal Medicine, Division of Hematology and Oncology, University of California, Davis, School of Medicine, Sacramento, CA, USA.
Michael L SteinbergDepartment of Radiation Oncology, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, USA.
Patrick A KupelianDepartment of Radiation Oncology, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, CA, USA.
Megan E DalyDepartment of Radiation Oncology, University of California, Davis, School of Medicine, Sacramento, CA, USA.
University of California, Los Angeles · USUniversity of California, Davis · US

Funding

Staff InvestigatorsP30CA093373 · NCI · UNIVERSITY OF CALIFORNIA DAVIS · PI Laura Marcu · 2002 to 2026
$84.9M
NCI NIH HHS P30 CA093373
6 · The paper itself

Abstract

backgroundHead and neck cancers positive for human papillomavirus (HPV) are exquisitely radiosensitive. We investigated whether chemoradiotherapy with reduced-dose radiation would maintain survival outcomes while improving tolerability for patients with HPV-positive oropharyngeal carcinoma.

methodsWe did a single-arm, phase 2 trial at two academic hospitals in the USA, enrolling patients with newly diagnosed, biopsy-proven stage III or IV squamous-cell carcinoma of the oropharynx, positive for HPV by p16 testing, and with Zubrod performance status scores of 0 or 1. Patients received two cycles of induction chemotherapy with 175 mg/m

findingsBetween Oct 4, 2012, and March 3, 2015, 45 patients were enrolled with a median age of 60 years (IQR 54-67). One patient did not receive treatment and 44 were included in the analysis. 24 (55%) patients with complete or partial responses to induction chemotherapy received 54 Gy radiation, and 20 (45%) with less than partial responses received 60 Gy. Median follow-up was 30 months (IQR 26-37). Three (7%) patients had locoregional recurrence and one (2%) had distant metastasis; 2-year progression-free survival was 92% (95% CI 77-97). 26 (39%) of 44 patients had grade 3 adverse events, but no grade 4 events were reported. The most common grade 3 events during induction chemotherapy were leucopenia (17 [39%]) and neutropenia (five [11%]), and during chemoradiotherapy were dysphagia (four [9%]) and mucositis (four [9%]). One (2%) of 44 patients was dependent on a gastrostomy tube at 3 months and none was dependent 6 months after treatment.

interpretationChemoradiotherapy with radiation doses reduced by 15-20% was associated with high progression-free survival and an improved toxicity profile compared with historical regimens using standard doses. Radiotherapy de-escalation has the potential to improve the therapeutic ratio and long-term function for these patients.

fundingUniversity of California.

Indexed as

Human papillomavirus 16Neoplasm Recurrence, LocalAgedAntineoplastic Combined Chemotherapy ProtocolsCarboplatinCarcinoma, Squamous CellChemoradiotherapyDeglutition DisordersDisease-Free SurvivalFollow-Up StudiesHumansInduction ChemotherapyLeukopeniaMaleMiddle AgedMucositisCarboplatinPaclitaxel

Identifiers

PMID28434660
PMCPMC6488353
OpenAlexW2607491790

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.