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Peer-reviewedCC BY 4.0Cancers

Retrospective Analysis of Efficacy and Toxicity of Low-Dose Weekly Cisplatin Concurrently with Radiotherapy for p16-Positive Oropharyngeal Squamous Cell Carcinoma

  • Nitin Niranjan1,2
  • Zulfiquer Otty3,4
  • Abhishek Joshi3,4
  • Marcus Hu1,4
  • Oskar Edkins4,5
  • Sarah Deacon6
  • Courtney Fisher7
  • Amy Brown3,4
  • Corinne Ryan3,4
  • Nathan Bain3,4
  • Joanne Tan3,4
  • Timothy Squire1,4
4 more authors
  • Simon Liebenberg5
  • Sabe Sabesan3,4
  • Daniel Tao Xing1,4,8
  • Shivanshan Pathmanathan3
8 affiliations
  1. 1Department of Radiation Oncology, Townsville University Hospital, Townsville, QLD 4814, Australia
  2. 2School of Medicine and Dentistry, Griffith University, Gold Coast, QLD 4222, Australia
  3. 3Department of Medical Oncology, Townsville University Hospital, Townsville, QLD 4814, Australia
  4. 4College of Medicine and Dentistry, James Cook University, Townsville, QLD 4814, Australia
  5. 5Department of Otolaryngology Head and Neck Surgery, Townsville University Hospital, Townsville, QLD 4814, Australia
  6. 6Department of Nutrition and Dietetics, Townsville University Hospital, Townsville, QLD 4814, Australia
  7. 7Department of Speech Pathology, Townsville University Hospital, Townsville, QLD 4814, Australia
  8. 8Australian Tropical Institute of Health and Medicine, James Cook University, Townsville, QLD 4814, Australia
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Abstract

Background: The incidence of p16-positive oropharyngeal squamous cell carcinoma (OPSCC) is increasing, with improved prognosis compared to non-HPV-related cancers. Standard treatment of locally advanced OPSCC involves high-dose cisplatin (HDC) with radiation but is associated with significant toxicity. Low-dose cisplatin (LDC) administered weekly has shown comparable efficacy to HDC in prior studies. This study evaluates the real-world outcomes of LDC in p16-positive OPSCC in a regional centre. Material and methods: Patients treated with curative radiation and concurrent LDC (40 mg/m2 weekly) for p16-positive OPSCC from January 2015 to December 2021 were retrospectively analysed (n = 103). Primary endpoints included overall survival (OS) and progression-free survival (PFS), with secondary endpoints being loco-regional and distant recurrence rates, and chemotherapy-related toxicity. Results: Overall survival rates were 94%, 89%, and 84% at two, three, and five years, respectively. The progression-free survival rates were 90%, 83%, and 80% over the same periods. The low-risk group showed excellent outcomes with no loco-regional recurrences and low distant relapse rates (6% at 5 years). The intermediate-risk group had higher loco-regional recurrences (10% at 5 years) and a similar distant relapse rate (7% at 5 years). T4 or N3 disease patients had lower survival and higher distant relapse rates but excellent loco-regional control. The median cumulative cisplatin dose was 240 mg/m2, with no survival difference between those receiving ≥200 mg/m2 versus less. Toxicity led to dose reductions (8%), delays (13%), and early cessations (30%). Conclusions: LDC is effective for p16-positive OPSCC with manageable toxicity, showing outcomes comparable to outcomes previously reported in studies using HDC.

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Cite

BibTeXRIS
BibTeX
@article{niranjan2026retrospective,
  title = {{Retrospective Analysis of Efficacy and Toxicity of Low-Dose Weekly Cisplatin Concurrently with Radiotherapy for p16-Positive Oropharyngeal Squamous Cell Carcinoma}},
  author = {Nitin Niranjan and Zulfiquer Otty and Abhishek Joshi and Marcus Hu and Oskar Edkins and Sarah Deacon and Courtney Fisher and Amy Brown and Corinne Ryan and Nathan Bain and Joanne Tan and Timothy Squire and Simon Liebenberg and Sabe Sabesan and Daniel Tao Xing and Shivanshan Pathmanathan},
  journal = {Cancers},
  year = {2026},
  month = oct,
  doi = {10.3390/cancers18203308},
  url = {https://www.mdpi.com/2072-6694/18/20/3308},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Retrospective Analysis of Efficacy and Toxicity of Low-Dose Weekly Cisplatin Concurrently with Radiotherapy for p16-Positive Oropharyngeal Squamous Cell Carcinoma
AU  - Nitin Niranjan
AU  - Zulfiquer Otty
AU  - Abhishek Joshi
AU  - Marcus Hu
AU  - Oskar Edkins
AU  - Sarah Deacon
AU  - Courtney Fisher
AU  - Amy Brown
AU  - Corinne Ryan
AU  - Nathan Bain
AU  - Joanne Tan
AU  - Timothy Squire
AU  - Simon Liebenberg
AU  - Sabe Sabesan
AU  - Daniel Tao Xing
AU  - Shivanshan Pathmanathan
PY  - 2026
DA  - 2026/10/01
JO  - Cancers
DO  - 10.3390/cancers18203308
UR  - https://www.mdpi.com/2072-6694/18/20/3308
AB  - Background: The incidence of p16-positive oropharyngeal squamous cell carcinoma (OPSCC) is increasing, with improved prognosis compared to non-HPV-related cancers. Standard treatment of locally advanced OPSCC involves high-dose cisplatin (HDC) with radiation but is associated with significant toxicity. Low-dose cisplatin (LDC) administered weekly has shown comparable efficacy to HDC in prior studies. This study evaluates the real-world outcomes of LDC in p16-positive OPSCC in a regional centre. Material and methods: Patients treated with curative radiation and concurrent LDC (40 mg/m2 weekly) for p16-positive OPSCC from January 2015 to December 2021 were retrospectively analysed (n = 103). Primary endpoints included overall survival (OS) and progression-free survival (PFS), with secondary endpoints being loco-regional and distant recurrence rates, and chemotherapy-related toxicity. Results: Overall survival rates were 94%, 89%, and 84% at two, three, and five years, respectively. The progression-free survival rates were 90%, 83%, and 80% over the same periods. The low-risk group showed excellent outcomes with no loco-regional recurrences and low distant relapse rates (6% at 5 years). The intermediate-risk group had higher loco-regional recurrences (10% at 5 years) and a similar distant relapse rate (7% at 5 years). T4 or N3 disease patients had lower survival and higher distant relapse rates but excellent loco-regional control. The median cumulative cisplatin dose was 240 mg/m2, with no survival difference between those receiving ≥200 mg/m2 versus less. Toxicity led to dose reductions (8%), delays (13%), and early cessations (30%). Conclusions: LDC is effective for p16-positive OPSCC with manageable toxicity, showing outcomes comparable to outcomes previously reported in studies using HDC.
SN  - 2072-6694
ER  -