Evidence map›Paper›PMID 33168055›Full record

ArticleRadiation oncology (London, England)2020

Modern treatment outcomes for early T-stage oropharyngeal cancer treated with intensity-modulated radiation therapy at a tertiary care institution.

Eric J Di Gravio, Pencilla Lang, Hugh Andrew Jinwook Kim, Tricia Chinnery, Neil Mundi, S Danielle MacNeil, Adrian Mendez, John Yoo, Kevin Fung, Joe S Mymryk and 10 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Radiation oncology (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Upfront transoral robotic surgery (TORS)Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale · 2022
    Review
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Eric J Di GravioDepartment of Otolaryngology - Head and Neck Surgery, Western University, London, ON, Canada.
Pencilla LangDepartment of Oncology, Western University, London, ON, Canada.
Hugh Andrew Jinwook KimDepartment of Otolaryngology - Head and Neck Surgery, Western University, London, ON, Canada.
Tricia ChinneryDepartment of Medical Biophysics, Western University, London, ON, Canada.
Neil MundiDepartment of Otolaryngology - Head and Neck Surgery, Western University, London, ON, Canada.
S Danielle MacNeilDepartment of Otolaryngology - Head and Neck Surgery, Western University, London, ON, Canada.
Adrian MendezDepartment of Otolaryngology - Head and Neck Surgery, Western University, London, ON, Canada.
John YooDepartment of Otolaryngology - Head and Neck Surgery, Western University, London, ON, Canada.
Kevin FungDepartment of Otolaryngology - Head and Neck Surgery, Western University, London, ON, Canada.
Joe S MymrykDepartment of Otolaryngology - Head and Neck Surgery, Western University, London, ON, Canada.
John W BarrettDepartment of Otolaryngology - Head and Neck Surgery, Western University, London, ON, Canada.
Nancy ReadDepartment of Oncology, Western University, London, ON, Canada.
Varagur VenkatesanDepartment of Oncology, Western University, London, ON, Canada.
Sara KuruvillaDepartment of Oncology, Western University, London, ON, Canada.
Lucas C MendezDepartment of Oncology, Western University, London, ON, Canada.
Eric WinquistDepartment of Otolaryngology - Head and Neck Surgery, Western University, London, ON, Canada.
Sylvia MitchellDepartment of Oncology, Western University, London, ON, Canada.
Sarah A MattonenDepartment of Oncology, Western University, London, ON, Canada.
Anthony C NicholsDepartment of Otolaryngology - Head and Neck Surgery, Western University, London, ON, Canada.
David A PalmaDepartment of Otolaryngology - Head and Neck Surgery, Western University, London, ON, Canada. david.palma@lhsc.on.ca.

Funding

CIHR 142491
6 · The paper itself

Abstract

backgroundTransoral surgery (TOS), particularly transoral robotic surgery (TORS) has become the preferred modality in the United States for the treatment of early stage oropharyngeal cancer, largely due to assumptions of fewer toxicities and improved quality of life compared to primary radiotherapy (RT). However, these assumptions are based on retrospective analysis, a subset of which utilize primary RT groups not limited to T1-2 stage tumors for which transoral robotic surgery is FDA approved. Thus, there is potential for underestimating survival and overestimating toxicity, including treatment related mortality, in primary RT.

methodsConsecutive cases of early T-stage (T1-T2) oropharyngeal cancer presenting to the London Health Sciences Centre between 2014 and 2018 treated with RT or chemoradiation (CRT) were reviewed. Patient demographics, treatment details, survival outcomes and toxicity were collected. Toxicities were retrospectively graded using the Common Terminology Criteria for Adverse Events criteria.

resultsA total of 198 patients were identified, of which 82% were male and 73% were HPV-positive. Sixty-eight percent of patients experienced a grade 2 toxicity, 48% a grade 3 and 4% a grade 4. The most frequent toxicities were dysphagia, neutropenia and ototoxicity. The rates of gastrostomy tube dependence at 1 and 2 years were 2.5% and 1% respectively. There were no grade 5 (fatal) toxicities. HPV-positive patients experienced improved 5-year overall survival (86% vs 64%, p = 0.0026).

conclusionsPrimary RT or CRT provides outstanding survival for early T-stage disease, with low rates of severe toxicity and feeding tube dependence. This study provides a reference for comparison for patients treated with primary transoral surgery.

Indexed as

AgedChemoradiotherapy, AdjuvantFemaleHumansMaleMiddle AgedNeoplasm StagingOropharyngeal NeoplasmsRadiotherapy, Intensity-ModulatedRetrospective StudiesSquamous Cell Carcinoma of Head and NeckTertiary Health CareChemoradiationOropharyngeal cancerRadiationToxicity

Identifiers

PMID33168055
PMCPMC7654053

What OpenQuestion holds

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Registered trials

None linked

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.