engleski

The response rate to individual treatment modalities in patients with HPV dependent and independent oropharyngeal tumors

Introduction: HPV status itself is probably the strongest prognostic factor in head and neck cancer (HNC) and in the near future it will probably determine the treatment intensity but it may also affect the choice of treatment modality. However, data evaluating the impact of HPV positivity on prognosis in HNC patients treated by different modalities are sparse. Aim: The aim of the study is to assess HPV status influence on the treatment outcome in groups of patients treated by surgery in combination with postoperative radiation therapy (RT) or by different non-surgical approaches. Methods: Patients with oropharyngeal tumors stage III and IV were included in this study. Out of 169 patients, 97 were treated by surgery and postoperative RT and 72 by non-surgical methods including chemotherapy and radiation therapy (CRT), concurrent RT and biological therapy or RT only. HPV DNA detection was done by PCR and the detection of p16 by immunohistochemistry. Samples were considered HPV positive if they were positive for both HPV DNA and expression of p16 protein. Survival analysis was done according to HPV status in both groups and also in the subgroups of different non-surgical therapies. Results: In the surgical group 64% of tumors were HPV positive, while it was only 28% in the non-surgically treated group. The disease-specific survival rate of patients with tumors causally linked with HPV was significantly higher than that of non-viral etiology tumor patients in both groups. However, the difference between survival of patients with HPV-positive and -negative tumors was more prominent in the surgical group. When stratified according to the treatment the survival was better in the surgical group. Conclusions: Patients with HPV positive tumors have better prognosis regardless of the treatment modality.

HPV; HNSCC

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