Oropharyngeal cancer radiotherapy protocols show improved patient-reported outcomes over time

Photo by Navy Medicine / Unsplash

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer Published May 13, 2026 Medically reviewed May 13, 2026 Study authors: Ullgren Helena, Fransson Per, Tiblom Ehrsson Ylva, Laurell Göran PubMed ↗ DOI ↗ By Dr. Julia Lee, PhD · Oncology, Genomics & Drug Development

Key Takeaway

Consider that later oropharyngeal cancer radiotherapy protocols were associated with better patient-reported outcomes over time.

This analysis combined an RCT (ARTSCAN1, 1998-2006) and an observational study (NIPHNC, 2015-2021) from Swedish multicentre settings. The population included 363 patients with oropharyngeal squamous cell carcinoma treated with curative-intent radiotherapy. The comparator was the earlier ARTSCAN1 cohort versus the later NIPHNC cohort.

The main results showed improvement in patient-reported outcomes (PROMs) at 2 years in both groups. The NIPHNC cohort reported fewer symptoms and lower anxiety or depression compared to the ARTSCAN1 cohort. However, absolute numbers, effect sizes, and p-values or confidence intervals were not reported for these outcomes.

Salivary symptoms, including dry mouth and sticky saliva, remained common and were noted as adverse events. Serious adverse events, discontinuations, and tolerability were not reported.

Key limitations include the lack of reported statistical measures, effect sizes, and absolute numbers. The practice relevance is that comparison of two treatment protocols demonstrates improvements in short- and long-term PROMs over time, but causality cannot be inferred from this observational design.

Study Details

Study typeRct

Sample sizen = 363

EvidenceLevel 2

PublishedMay 2026

PMID42126618

View Original Abstract ↓

PURPOSE: Long-term patient-reported outcomes (PROMs) may provide insight into the impact of advances in the treatment of oropharyngeal squamous cell carcinoma (OPSCC). The main aim of the study was to assess and compare PROMs in OPSCC patients treated during two different periods (1998-2006 vs. 2015-2021), reflecting advances in treatment strategies and developments in care. METHODS: The present study is based on data from two Swedish multicentre studies: the randomised controlled trial ARTSCAN1 (1998-2006) and the observational study NIPHNC (2015-2021). Patients received curative-intent radiotherapy as part of the ARTSCAN or NIPHNC studies. All patients completed PROMs at multiple time points up to 24 months post-treatment. PROMs were assessed using the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire EORTC QLQ-H&N35 and the Hospital Anxiety and Depression Scale HADS. RESULTS: A total of 363 patients were included, with 161 and 202 patients from ARTSCAN1 and NIPHNC, respectively. At baseline and at all post-radiotherapy time points, the NIPHNC cohort reported fewer symptoms and lower anxiety/depression. At 2 years, both groups showed improvement, though persistent issues like dry mouth and sticky saliva remained common. CONCLUSIONS: Comparison of two treatment protocols demonstrates improvements in short- and long-term PROMs over time. Long-term salivary symptoms remain prevalent in patients with OPSCC.