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Review ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Oncol. | doi: 10.3389/fonc.2019.00936

Deintensification of Adjuvant Treatment After Transoral Surgery in Patients with Human Papillomavirus-positive Oropharyngeal Cancer: The conception of the PATHOS Study and its development

 Sarah Hargreaves1, Matthew Beasley2,  Chris Hurt3,  Terry M. Jones4 and Mererid Evans1*
  • 1Velindre NHS Trust, United Kingdom
  • 2University Hospitals Bristol NHS Foundation Trust, United Kingdom
  • 3Centre for Trials Research, Cardiff University, United Kingdom
  • 4University of Liverpool, United Kingdom

PATHOS is a phase II/III randomised controlled trial (RCT) of risk-stratified, reduced intensity adjuvant treatment in patients undergoing transoral surgery (TOS) for human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC). The study opened in the UK in October 2015 and, after successful recruitment into the phase II, transitioned into phase III in the autumn of 2018. PATHOS aims to establish whether the de-intensification of adjuvant treatment in patients with favourable prognosis HPV-positive OPSCC will confer improved swallowing outcomes, whilst maintaining high rates of cure. In this article, we will outline the rationale for the study and how it aims to answer fundamentally important questions about the safety, effectiveness and functional outcomes of minimally invasive TOS techniques followed by adjuvant radiotherapy (RT) or chemo-radiotherapy (CRT) in this patient population.

Keywords: HPV- related head and neck squamous cell carcinoma, Pathos, Deintensification, Transoral surgery, adjuvant

Received: 13 May 2019; Accepted: 06 Sep 2019.

Copyright: © 2019 Hargreaves, Beasley, Hurt, Jones and Evans. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Mererid Evans, Velindre NHS Trust, Cardiff, United Kingdom,