3692 - Treatment Outcome Priorities for Patients with Human Papillomavirus-Associated Oropharyngeal Cancer (HPVOPC) before and 12 Months after Primary (Chemo)Radiation (CRT/RT): Results from a Prospective Lo

L. J. McDowell¹, K. Gough², T. Fua², A. Coleman², A. Drosdowsky², D. Rischin², and J. Corry³; ¹Princess Alexandra Hospital, Brisbane, QLD, Australia, ²Peter MacCallum Cancer Center, Melbourne, VIC, Australia, ³Genesiscare, St Vincents Hospital, Melbourne, Australia

Purpose/Objective(s): This study constitutes a planned secondary endpoint analysis of oncological and functional-related treatment outcome priorities of patients with HPVOPC before and after primary CRT/RT. Materials/

Methods: Patients diagnosed with HPVOPC who were suitable for curative-intent primary CRT/RT were eligible to participate. Patient-reported outcome measures included a modified version of the Chicago Priorities Scale (CPS-modified), which incorporated a ‘keeping my sexual function’ item. The 13-item CPS-modified was administered before and 12 months after CRT/RT. Patients first classified items as top, middle and low priorities (=6 items/group) and then ranked items within each priority group, resulting in a possible rank of 1 to 13 for each item. Only patients with valid item responses at both assessments were included in the analysis. Paired responses (top priority before and after CRT/RT) were compared with the exact McNemar test.

Results: From October 2020 to November 2021, 100 eligible patients were enrolled: median age 61 years (range 44-79), 87% male, 52% stage I and 97% receiving concurrent CRT. Of enrolled patients, 99/100 and 90/98 completed the CPS-modified before and after CRT/RT, respectively. Based on items classified as a top priority, the top five priorities were consistent over time (before/after CRT/RT): ‘being cured of my cancer’ (93%/91%), ‘living as long as possible’ (69%/66%), ‘being able to swallow all foods and drinks’ (56%/56%), ‘having a normal amount of energy’ (51%/48%) and ‘having no pain’ (51%/48%). Compared with before CRT/RT, more patients classified ‘keeping my normal sense of taste and smell’ and ‘having a comfortably moist mouth’ as a top priority 12 months after CRT/RT (26%/44%, p=0.002; and 19%/39%, p=0.003, respectively). After CRT/RT, ‘being cured of my cancer’ and ‘living as long as possible’ were ranked ‘1’ (of all 13 items) by 73% and 12% of patients, respectively. The frequency with which patients ranked the swallowing item above other highly prioritized items after CRT/RT were: ‘being cured of my cancer (14%), ‘living as long as possible’ (36%), ‘having no pain’ (47%), ‘having a normal amount of energy’ (54%), ‘keeping my normal sense of taste and smell’ (54%) and ‘having a comfortably moist mouth’ (66%).

Conclusion: For HPVOPC patients, the most important oncological and functional-related treatment priorities remain stable before and after treatment. While HPVOPC survivors in this study frequently ranked swallowing within their top survivorship priorities, nearly half (44%) did not, and only 14% ranked it higher than being cured of their cancer. Patient priorities should be considered when designing aggressive de-escalation treatment strategies.