Conditional Survival Among Patients with Oropharyngeal Cancer Treated with Radiation Therapy and Alive Without Recurrence 5 Years After Diagnosis

Authors

Kristina R Dahlstrom
Juhee Song
Peter F Thall
Clifton D Fuller
Katherine A Hutcheson
Faye M Johnson
G Brandon Gunn
Jack Phan
Steven J Frank
William H Morrison
Renata Ferrarotto
David I Rosenthal
Erich M Sturgis
Adam S Garden

Publication Date

4-15-2021

Journal

Cancer

DOI

10.1002/cncr.33370

PMID

33306202

PMCID

PMC8058232

PubMedCentral® Posted Date

4-15-2022

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

no

Keywords

Age Factors, Aged, Bayes Theorem, Cancer Survivors, Cause of Death, Ex-Smokers, Female, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Neoplasm Recurrence, Local, Oropharyngeal Neoplasms, Radiotherapy Dosage, Radiotherapy, Intensity-Modulated, Retrospective Studies, Smokers, Time Factors, Tongue Neoplasms

Abstract

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.

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