{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T08:20:23Z","timestamp":1791534023283,"version":"4.3.4"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,5,23]],"date-time":"2019-05-23T00:00:00Z","timestamp":1558569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Numerous trials are evaluating radiotherapy (RT) de\u2010escalation for human papillomavirus (HPV)\u2010mediated (HPV+) oropharyngeal squamous cell carcinoma (OPSCC). Herein, we evaluated the degree to which de\u2010escalated RT is delivered in the United States, as well as comparative outcomes with full\u2010dose RT as stratified for HPV status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective database review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified patients diagnosed with OPSCC in the National Cancer Database, excluding those with stage I\/II disease, unknown HPV status, receiving surgery or not receiving external beam radiation therapy to the primary site, receipt of radiation doses &gt;75 or\u2009&lt;54 Gy, radiation treatment course duration &lt;25 or\u2009&gt;75 days, and unknown or inadequate (&lt;2 months) follow\u2010up. Multivariable logistic regression analysis identified variables associated with delivery of de\u2010escalated RT (&lt;66 Gy). Overall survival of HPV+ and non\u2013HPV\u2010mediated (HPV\u2212) disease was compared between full\u2010dose and de\u2010escalated approaches.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Altogether, 617 and 551 patients were HPV+ and HPV\u2212, respectively. De\u2010escalated RT was delivered in 16.9% HPV+ and 15.2% of HPV\u2212\u2009disease, respectively. Older patients and omission of systemic therapy were more likely to receive de\u2010escalated RT. In HPV+ patients, 3\u2010 and 5\u2010year survival rates were 83% and 80% in the de\u2010escalated cohort versus 83% and 78% in the full\u2010dose group (<jats:italic>P<\/jats:italic> =\u2009.83). In HPV\u2212 patients, corresponding 3\u2010 and 5\u2010year survival rates were 29% and 23% versus 61% and 51% (<jats:italic>P<\/jats:italic> =\u2009.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>National utilization of de\u2010escalated RT for OPSCC is low (15%\u201320%), but does not seem to impact overall survival in HPV+ (but not HPV\u2212) patients. The caveats of this heterogeneous, retrospective analysis require corroboration from a number of ongoing randomized trials.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2c <jats:italic>Laryngoscope<\/jats:italic>, 130:E171\u2013E176, 2020<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.28083","type":"journal-article","created":{"date-parts":[[2019,5,23]],"date-time":"2019-05-23T17:54:46Z","timestamp":1558634086000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Practice patterns and outcomes following radiation dose de\u2010escalation for oropharyngeal cancer"],"prefix":"10.1002","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7891-721X","authenticated-orcid":false,"given":"Richard","family":"White","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Allegheny Health Network  Pittsburgh Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Abel","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology Allegheny Health Network Cancer Institute  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaakir","family":"Hasan","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology Allegheny Health Network Cancer Institute  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek","family":"Verma","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology Allegheny Health Network Cancer Institute  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Larisa","family":"Greenberg","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology Allegheny Health Network Cancer Institute  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios","family":"Colonias","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology Allegheny Health Network Cancer Institute  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney E.","family":"Wegner","sequence":"additional","affiliation":[{"name":"Division of Radiation Oncology Allegheny Health Network Cancer Institute  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,5,23]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"FooteRL GilbertJ GillisonML et al. Continue NCCN Guidelines Panel Disclosures. Version 2.2018 head and neck cancers. National Comprehensive Cancer Network website. Available at:https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/head-and-neck.pdf. Accessed January 27 2019."},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2017.05.008"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0912217"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23351"},{"key":"e_1_2_6_6_1","volume-title":"AJCC Cancer Staging Manual","author":"Amin MB","year":"2019"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdy522"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2017.09.021"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2006.06.040"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20069"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdh101"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.currproblcancer.2003.10.002"},{"key":"e_1_2_6_13_1","unstructured":"Evaluation of De\u2010escalated Adjuvant Radiation Therapy for Human Papillomavirus (HPV)\u2010Associated Oropharynx Cancer. 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