BackgroundDe‐escalation strategies for newly‐diagnosed p16‐positive oropharyngeal squamous cell carcinoma (p16+ OPSCC), aim to reduce treatment‐related morbidity without compromising disease control. One strategy is neoadjuvant cisplatin and docetaxel chemotherapy (NAC + S) before transoral robotic surgery, with pathology‐based risk‐adapted adjuvant treatment.MethodsWe examined the recurrence‐free survival (RFS) for patients who received NAC + S.ResultsComparing outcomes in 103 patients between 2008 and 2023, 92% avoided adjuvant treatment and showed significantly higher 2‐year recurrence‐free survival (RFS) compared to those with adjuvant treatment (95.9% vs. 43.8%, p = 0.0049)ConclusionOur findings suggest that pathology‐based risk‐adapted omission of adjuvant treatment following NAC + S does not appear to elevate recurrence risk and that NAC may identify patients with favorable tumor biology, yielding a 2‐year RFS probability exceeding 95% without adjuvant treatment. Further, the study identifies a patient subset experiencing disease recurrence despite triple modality therapy. Despite limitations, including a retrospective design and modest sample size, the data advocate for controlled NAC + S studies.

中文翻译：

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避免辅助放疗的口咽癌患者接受新辅助化疗和经口机器人手术后复发的风险

背景新诊断的 p16 阳性口咽鳞状细胞癌 (p16+ OPSCC) 的降级策略旨在在不影响疾病控制的情况下降低治疗相关的发病率。一种策略是在经口机器人手术前进行新辅助顺铂和多西他赛化疗 (NAC + S)，并进行基于病理学的风险适应辅助治疗。方法我们检查了接受 NAC + S 的患者的无复发生存期 (RFS)。结果比较了 103 名患者的结果在 2008 年至 2023 年间的患者中，92% 的患者避免了辅助治疗，并且与接受辅助治疗的患者相比，其 2 年无复发生存率 (RFS) 显着更高（95.9% vs. 43.8%，p= 0.0049）结论我们的研究结果表明，NAC + S 后基于病理的风险适应辅助治疗的省略似乎不会增加复发风险，并且 NAC 可以识别具有良好肿瘤生物学的患者，产生超过 95% 的 2 年 RFS 概率，而无需辅助治疗。此外，该研究还确定了尽管三联治疗仍经历疾病复发的患者亚群。尽管存在局限性，包括回顾性设计和适度的样本量，但数据主张进行对照 NAC + S 研究。