Disparities in Proton Radiation Utilization for HPV-Associated Oropharyngeal Cancer Following TORS

Racial, socioeconomic, and geographic disparities in receipt of proton radiation have been reported. Whether disparities exist for oropharyngeal squamous cell carcinoma (OPSCC) is not well studied.

Patients with HPV-associated OPSCC treated with transoral robotic surgery (TORS) and adjuvant radiation from 2016 to 2023 were reviewed. Demographics, disease characteristics, treatment details, and socioeconomic variables were collected.

Of 116 patients, 102 (87.9%) were male, 105 (90.5%) White, with a median age of 59.7 years. Fifty (43.1%) received proton radiation. Age, gender, race, tumor subsite, tumor and nodal staging, insurance, employment, and distance from our institution were not significantly associated with proton radiation, while higher median income was (p = 0.04).

While higher median income was significantly associated with proton radiation, other traditionally described disparities were not apparent for HPV-associated OPSCC treated with TORS. Although this cohort included predominantly privately insured White males, access to adjuvant proton therapy seemed to be equitably available across demographics.