Impact of HPV infection on the clinical outcome of p-CAIR trial in head and neck cancer
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Miroslaw Snietura Wojciech Piglowski Magdalena Jaworska Anna Mucha-Malecka Grzegorz Wozniak Dariusz Lange Rafal Suwinski
- چاپ و سال / کشور: 2011
Description
The purpose of the study was to analyse the influence of HPV infection on the outcome of a randomized clinical trial of conventional (CF) versus 7-daysa- week postoperative radiotherapy (p-CAIR) for squamous cell cancer of the head and neck (SCCHN). Between 2001 and 2004, 279 patients with high-risk SCC of the larynx or cancer of the oral cavity/oropharynx were randomized to receive 63 Gy in fractions of 1.8 Gy given 5 days a week or 7 days a week (Radiother Oncol 87:155–163, 2008). The presence of HPV DNA in 131 archival paraffin blocks was assessed with multiplex quantitative real-time PCR using five consensus primers for the conservative L1 region and molecular beacon probes targeting 14 high-risk HPV subtypes. Following the RT-PCR procedure, we could determine the presence and type of HPV16, HPV18 and the other 12 less frequent oncogenic subtypes. Out of 131 samples, 9 were positive for HPV infection (6.9%), all of them with HPV16 subtype. None of the 65 laryngeal tumours was HPV positive. The 5-year LRC in HPVpositive patients was 100%, compared to 58% in the HPVnegative group (p = 0.02, log-rank test). Amongst 122 patients with HPV-negative tumours, 5-year LRC was 50.3% in p-CF versus 65.2 in p-CAIR (p = 0.37). HPV infection was associated with low expression of EGFR and cyclin D. This study demonstrates a favourable outcome for HPV-positive patients with SCCHN treated with postoperative radiotherapy. While considering the small number of HPV? tumours, the data set can be considered as hypothesis generating only, the outcome raises new questions on the necessity of aggressive postoperative treatment in HPV? patients.
Eur Arch Otorhinolaryngol (2011) 268:721–726, Received: 30 July 2010 / Accepted: 24 September 2010 / Published online: 12 October 2010 The Author(s) 2010. This article is published with open access at Springerlink.com
