Lower-level radiation and chemotherapy may be as effective as standard doses for some patients with human papillomavirus (HPV)-related cancer of the throat, tonsils and tongue, and may cause fewer side effects, researchers say.
The study included 43 patients who had “favorable risk” HPV-associated oropharyngeal (tonsils and tongue) cancer and were not heavy smokers. Compared to standard treatment, their radiation therapy was reduced by 16 percent and their chemotherapy dose was reduced by 60 percent.
After an average follow-up of nearly 21 months (range of 6 to 36 months), all of the patients were alive with no evidence of cancer recurrence, according to the report.
The patients had fewer side effects — such as mouth dryness, swallowing problems, nausea, vomiting and inflammation of the membranes lining the digestive tract — compared with patients who received standard treatment, the investigators found.
Only 39 percent of the patients in the study required feeding tubes, none of which were permanent. That compares to feeding tube rates of up to 80 percent — about 10 percent of which are permanent — for patients receiving standard treatment.
The study findings were presented Oct. 18 at the American Society for Radiation Oncology’s annual meeting in San Antonio. Findings presented at medical meetings are typically considered preliminary because they have not undergone a peer review.
“Our study provides strong preliminary evidence that reduced-intensity chemoradiotherapy may be as effective as standard-dose chemoradiotherapy,” lead study author Dr. Bhishamjit Chera, associate professor of radiation oncology at University of North Carolina School of Medicine, said in a society news release.
With more study, Chera said, the regimen could become standard care for carefully selected patients with HPV-associated squamous cell carcinoma of the tonsils and tongue. “The results so far are certainly encouraging, and with longer follow-ups, we hope to confirm less long-term side effects, as well,” Chera added.
Rising rates of tongue and tonsil cancers are believed to be due to HPV infection, according to background information in the news release.
The U.S. National Cancer Institute has more about oropharyngeal cancer treatment.