A new study from researchers at the University of Texas Southwestern Medical Center in Dallas found no major long-term differences in the effectiveness of radiation therapy versus surgery in treating oropharyngeal squamous cell carcinoma (OPSCC). Given these results, investigators suggest quality-of-life factors should help inform a treatment decision.
The findings compared the effectiveness of definitive radiotherapy with primary surgery. The investigators performed a comparative effectiveness analysis in patients with oropharyngeal squamous cell carcinoma, focusing on survival, side effects, and costs. The study merged the HealthCore Integrated Research Database with state cancer registry data to identify 884 patients diagnosed with OPSCC from 2007 to 2014. The authors found no statistical differences between radiotherapy versus surgery in overall survival, long-term gastrostomy dependence, esophageal dilation or restriction, and bone toxicity effects. There was, however, an increase in acute gastrostomy use among radiotherapy patients who also received chemotherapy.
“While historical treatment outcomes for oropharyngeal cancer were quite poor, the combination of treatment innovations and more favorable tumor biology have resulted in three-year survival for more than 75% of patients in this analysis,” said David Sher, MD, MPH, associate professor of radiation oncology in the department of clinical science at UT Southwestern, and first author of the study.
Dr. Sher said that future research in this area should focus not just on oncologic results but also on patient quality of life and functional outcomes. “Both local therapy paradigms for HPV-associated oropharyngeal cancer are expected to change significantly over the next five years, so it is crucial to prospectively study the impact of novel treatment approaches on patient-centered outcomes.”
Further, the study showed that, for both treatments, costs were approximately $100,000 for payers and $5,000 for patients. Dr. Sher said, “The absence of any significant cost differences further emphasizes how central patient-reported outcomes will be on the comparative value of the two therapies.”