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Survival Benefit of Chemotherapy in Oropharyngeal Cancer Patients Treated with Surgery and Post-Operative Radiation

  • Author / Creator
    Makki, Fawaz M
  • Oropharyngeal squamous cell carcinoma (OPSCC) is the third most common cancer of the head and neck. The incidence of all subtypes of head and neck squamous cell carcinoma has decreased over the past 30 years in Canada and most of the world except for OPSCC. The increasing incidence of OPSCC over the past 10-20 years is driven by Human Papilloma Virus (HPV) type 16 infection. The benefit of chemotherapy in the post-surgical treatment of advanced stage OPSCC is unclear in the current literature especially after the emergence of HPV related OPSCC. This thesis investigated the survival benefit of adding chemotherapy in the primary surgical setting followed by adjuvant radiation therapy in the management of all patients with advanced stage OPSCC. We hypothesized that chemotherapy could have a survival advantage dependent on p16 and tobacco smoking history. Comparative survival analyses were performed between patients who received surgery + radiation therapy (S+RT) and surgery + chemoradiation therapy (S+CRT), stratified according to p16 status and tobacco smoking history. After adjustment for all covariates, smoking status and extracapsular extension were both independent predictors of survival. In our survival analysis for the whole cohort, the addition of chemotherapy was associated with a statistically significant better 5-year overall survival. After stratifying based on their p16 and smoking status, smokers showed a statistically significant better survival benefit from the addition of chemotherapy in post-operative setting. However, further prospective trials that include p16 and smoking status would be recommended to verify this hypothesis.

  • Subjects / Keywords
  • Graduation date
    2017-11:Fall 2017
  • Type of Item
    Thesis
  • Degree
    Master of Science
  • DOI
    https://doi.org/10.7939/R33T9DM3Z
  • License
    This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.
  • Language
    English
  • Institution
    University of Alberta
  • Degree level
    Master's
  • Department
    • School of Public Health
  • Specialization
    • Clinical epidemiology
  • Supervisor / co-supervisor and their department(s)
    • Biron, Vincent (Assistant Professor, Department os Surgery, Division of Otolaryngology Head & Neck Surgery, University of Alberta Hospital))
    • Davis, Faith (Professor and Vice-Dean, School of Public Health, University of Alberta)
  • Examining committee members and their departments
    • Peterson, Caryn E. (Research Assistant Professor University of Illinois at Chicago, School of Public Health)
    • Davis, Faith (Professor and Vice-Dean, School of Public Health, University of Alberta)
    • Biron, Vincent (Assistant Professor, Department os Surgery, Division of Otolaryngology Head & Neck Surgery, University of Alberta Hospital))