Treatment outcomes for human papillomavirus negative oropharyngeal cancer: A meta-analysis

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso Pub Date : 2025-04-01 DOI:10.1016/j.ejso.2025.110005

Smriti Panda , Kurinchi S. Gurusamy , Alok Thakar , Sandipta Mitra , Raghav Dwivedi , Francesca Angela Chiumenti

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引用次数: 0

Abstract

Background

Current treatment guidelines for HPV-negative oropharyngeal squamous cell carcinoma (OPSCC), the predominant form of OPSCC in Asia, are largely extrapolated from the evidence available from HPV-associated OPSCC due to a paucity in the literature in terms of the best treatment option for these cancers.

Methods

Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE, EMBASE and clinical trial registries were searched from January 01, 2009 to June 20, 2023 for studies comparing at least two interventions [randomized (RCT)and non-randomized] performed as primary curative treatment in HPV-negative OPSCC. Random effects model was used for the meta-analysis.

Results

Forty-seven studies could be included (randomized controlled trials: 12, 1230 participants; non-randomized cohort studies: 35, 44253 participants). The largest comparison in the non-randomized studies was between upfront surgery and non-surgical intervention [RT/concurrent chemoradiation (CRT)] with 24 studies. The outcomes in the former for overall survival (HR:0.63, 95 %C.I: 0.56, 0.71) and disease-free survival (HR:0.48, 95 %C.I: 0.30, 0.76) were found to be superior (risk of bias: “high” or “serious”). Due to the lack of reporting of treatment-related toxicity and health-related quality of life, meta-analysis could not be performed for these outcomes.

Conclusion

and Relevance: Upfront surgery showed superior outcomes in terms of OS and DFS compared with non-surgical modalities in HPV-negative OPSCC, but the observed differences may be due to confounding bias. Toxicity and quality of life reporting was sparse.

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人乳头瘤病毒阴性口咽癌的治疗结果：荟萃分析

背景HPV阴性口咽鳞状细胞癌（OPSCC）是亚洲最常见的口咽鳞状细胞癌，目前的治疗指南主要是从HPV相关口咽鳞状细胞癌的现有证据中推断出来的，因为这些癌症的最佳治疗方案方面的文献很少。方法检索了2009年1月1日至2023年6月20日期间的Cochrane对照试验中央注册中心（CENTRAL）（Cochrane图书馆）、MEDLINE、EMBASE和临床试验注册中心的文献，以比较至少两种干预方法（随机（RCT）和非随机）作为HPV阴性OPSCC的主要治疗方法。荟萃分析采用随机效应模型：随机对照试验：12 项，1230 人参与；非随机队列研究：35 项，44253 人参与）：35项，44253名参与者）。在非随机研究中，前期手术与非手术干预[RT/同期化疗（CRT）]之间的比较最多，共有24项研究。前者的总生存期（HR：0.63，95 %C.I：0.56，0.71）和无病生存期（HR：0.48，95 %C.I：0.30，0.76）结果更优（偏倚风险："高 "或 "严重"）。由于缺乏治疗相关毒性和健康相关生活质量的报告，因此无法对这些结果进行荟萃分析：在HPV阴性OPSCC患者中，前期手术在OS和DFS方面的疗效优于非手术疗法，但观察到的差异可能是由于混杂偏倚造成的。关于毒性和生活质量的报告很少。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ejso 医学-外科

CiteScore

6.40

自引率

2.60%

发文量

1148

审稿时长

41 days

期刊介绍： JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.