Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Georges Pompidou European Hospital, Paris Cité University, 20 rue Leblanc, Paris, France.
Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Guy's Hospital, Great Maze Pond, London, England.
Eur Arch Otorhinolaryngol. 2023 Aug;280(8):3811-3820. doi: 10.1007/s00405-023-07952-8. Epub 2023 Apr 3.
Although HPV-positive and negative oropharyngeal cancers are two distinct diseases, Post-Therapeutic Surveillance (PTS) modalities are similar. Adjusting PTS strategies to HPV status will represent a massive practice change that raises the issue of its acceptability, by both physicians and patients.
Two distinct surveys were designed and submitted, respectively, to HPV-positive patients and physicians (surgeons, radiation and medical oncologists) involved in head and neck cancer treatment.
133 patients and 90 physicians have participated to the study. Most patients were reluctant to embrace new PTS options (remote consultations, nurse consultations and smart phone applications). However, 84% of patients would be favorable to use HPV Circulating DNA (HPV Ct DNA) measurement to guide surveillance modalities. 57% of physicians acknowledged that our current PTS strategy is improvable and most of them would accept the use of new monitoring options from the third year of follow-up. 87% of physicians would be interested to participate to a trial comparing the current PTS strategy to a new approach, where monitoring modalities (number of visits, imaging prescription) would depend on HPV Ct DNA level.
Patients and physicians are aware that PTS modalities should depend on HPV status. Their adhesion is a prerequisite to any potential changes. Strategies based on HPV Ct DNA measurement should be assessed within a randomized clinical trial.
尽管 HPV 阳性和阴性口咽癌是两种截然不同的疾病，但治疗后监测 (PTS) 方式相似。根据 HPV 状态调整 PTS 策略将代表着巨大的实践转变，这将引发医生和患者对其可接受性的关注。
分别设计并提交了两个不同的调查，分别针对 HPV 阳性的患者和参与头颈部癌症治疗的医生（外科医生、放射治疗师和肿瘤内科医生）。
共有 133 名患者和 90 名医生参与了这项研究。大多数患者不愿意接受新的 PTS 选择（远程咨询、护士咨询和智能手机应用）。然而，84%的患者赞成使用 HPV 循环 DNA（HPV Ct DNA）测量来指导监测方式。57%的医生承认我们目前的 PTS 策略可以改进，他们中的大多数人将接受从随访第三年开始使用新的监测选项。87%的医生有兴趣参与一项比较当前 PTS 策略和新方法的试验，其中监测方式（就诊次数、影像检查处方）将取决于 HPV Ct DNA 水平。
患者和医生都意识到 PTS 方式应取决于 HPV 状态。他们的认同是任何潜在变化的前提。基于 HPV Ct DNA 测量的策略应在随机临床试验中进行评估。
