Cohort study of deintensified chemoradiotherapy for HPV-associated oropharyngeal carcinoma

Standard treatment for HPV-associated oropharyngeal carcinoma (OPC) of the includes 7 weeks of intensive chemoradiotherapy with substantial toxic effects. A cohort study at multiple centers under one academic hospital system evaluated long-term oncologic outcomes among patients with HPV-associated OPC treated with definitive deintensified (chemo)radiotherapy. The study included 240 patients with a clinical stage from T0 to T3 and N0 to N2c, who between September 2014 and August 2022 were treated with 60-Gy IMRT with weekly cisplatin. Patients with a clinical stage from T0 to T2 and N0 to N1 were recommended 60-Gy IMRT alone. The 5-year locoregional recurrence rate was 3.4%. Among the patients receiving radiotherapy alone, the 5-year progression-free survival rate was 93.8%, with no patient experiencing a locoregional recurrence. The authors conclude that modest deintensification of CRT in patients with HPV-associated OPC showed favorable rates of locoregional control.