A research report submitted to the Faculty of Health Sciences, University of the
Witwatersrand, Johannesburg, in partial fulfilment of the requirement for the degree of
Masters of Medicine in the branch of Radiation Oncology
Johannesburg 2015 / Radiation therapy is a highly effective method of treating oropharyngeal carcinoma, either as
a single modality treatment with concurrent chemotherapy or as an adjuvant treatment after
surgical resection. There exists an association with human papillomavirus (HPV) and
oropharyngeal cancer, dividing oropharyngeal carcinoma into HPV positive oropharyngeal
carcinoma and HPV negative oropharyngeal carcinoma. Overall survival has been analysed
in these two groups and have been shown to be 80-95% for HPV positive oropharyngeal
carcinomas and 57-62% in HPV negative subgroup at 3 years respectively. This retrospective
review was intended to analyse patient response to treatment, overall survival, local disease
free survival and the difference between HPV positive oropharyngeal carcinoma and HPV
negative oropharyngeal carcinoma at Charlotte Maxeke Johannesburg Academic Hospital:
Department of Radiation Oncology.
Patients and methods
A retrospective descriptive study was conducted on patients having received radical radiation
therapy, with or without chemotherapy, from January 2009 to December 2012 with a
histologically confirmed diagnosis of squamous cell carcinoma involving oropharyngeal sites
only. The information obtained from records of forty-eight patients was captured on the
prescribed data sheets designed for this study.
Results
Forty-eight eligible patients were accrued within this retrospective study. The median age of
the patient group was 56 years (range 32-78) and comprised of 10 females and 38 males. The
performance status was mainly Eastern Cooperative Oncology Group (ECOG) 1 (83%). The
radiation therapy dose was within the range 60-70Gy, with majority patients completing 70
Gy (65%). Concurrent chemoradiation was given in 59% of patient group (28 patients). The
most common site being the base of tongue (60%), followed by tonsil (36%), soft palate (2%)
and posterior pharyngeal wall (2%). Eighty five percent of patients were stage IV
oropharyngeal carcinoma. Only 6% of patients were tested for HPV-DNA PCR, and all were
HPV positive. A total of 79% patients had a positive smoking history and 50% consumed
alcohol regularly. Fifty six percent of patients tested negative for HIV, 14.6% tested positive
for HIV and 29.3% had unknown HIV status.
At the time of the analyses (March 2014) only 7 (15%) of patients were alive. The 2 year
overall survival was 13%, the local disease free survival at 2 years was 59%. None of the
prognostic factors were predictive of overall survival using univariate and multivariate
analysis.
Conclusion
Majority of patients present in stage IV lesions with commonest sites of involvement being
Base of Tongue. The local disease free survival of 2 years was 59% and the overall survival
of 15%. There was no impact of prognostic factors studied on overall survival.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/18478 |
| Date | January 2015 |
| Creators | Ramdas, Yastira |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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