Prognostic significance of HPV status in the re-irradiation of recurrent and second primary cancers of the head and neck

Autor: Maria A. Velez, Elliot Abemayor, Sophia Hsu, Maie A. St. John, Allen M. Chen, Robert Chin, Pin-Chieh Wang, Philip Beron
Rok vydání: 2018
Předmět:
Adult
Male
0301 basic medicine
Oncology
Re-Irradiation
medicine.medical_specialty
medicine.medical_treatment
Population
Kaplan-Meier Estimate
Risk Assessment
Disease-Free Survival
Statistics
Nonparametric
Cohort Studies
Young Adult
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
education
Papillomaviridae
Aged
Retrospective Studies
Aged
80 and over
education.field_of_study
business.industry
Medical record
Papillomavirus Infections
Head and neck cancer
Neoplasms
Second Primary
Radiotherapy Dosage
Middle Aged
Prognosis
medicine.disease
Survival Analysis
Radiation therapy
Treatment Outcome
030104 developmental biology
Otorhinolaryngology
Head and Neck Neoplasms
030220 oncology & carcinogenesis
Cohort
Carcinoma
Squamous Cell
Biomarker (medicine)
Female
Neoplasm Recurrence
Local
business
Cohort study
Zdroj: American Journal of Otolaryngology. 39:257-260
ISSN: 0196-0709
DOI: 10.1016/j.amjoto.2018.01.011
Popis: Purpose To evaluate the prognostic significance of human papillomavirus (HPV) status among patients treated by salvage radiation therapy for local-regional recurrences and second primary cancers of the head and neck arising in a previously irradiated field. Methods and materials The medical records of 54 consecutive patients who underwent re-irradiation for squamous cell carcinoma of the head and neck occurring in a previously irradiated field were reviewed. Only patients with biopsy-proven evidence of recurrent disease that had previously been treated with doses of radiation therapy of at least 60 Gy were included. Determination of HPV status at the time of recurrence was performed by p16 immunohistochemistry. The median age at re-irradiation was 58.5 years (range, 27.9 to 81.5 years). Thirty patients (55.5%) were lifelong never-smokers. The Kaplan Meier method was used to calculate overall survival, progression-free survival, and local-regional control, and distant metastasis-free survival with comparisons between groups performed using the log-rank test. Results HPV status among tumors that were re-irradiated was as follows: 16 positive (29.7%); 7 negative (12.9%); 31 unknown (57.4%). The median overall survival in the entire cohort was 11.7 months (range, 8 to 27 months), with the 1-year and 2-year estimates of overall survival being 47.2% and 38.4%, respectively. A statistical trend was identified favoring patients with HPV-positive cancers with respect to the endpoints of overall survival (p = 0.06) and progression-free survival (p = 0.08) after re-irradiation when compared to the HPV-negative/unknown population. There was no significant difference in distant control between the two cohorts (p = 0.40). Conclusions The favorable prognostic significance of HPV seemingly extends to patients treated by re-irradiation suggesting that this biomarker may be useful in risk stratification in this setting.
Databáze: OpenAIRE
Externí odkaz: