Classical risk factors, but not HPV status, predict survival after chemoradiotherapy in advanced head and neck cancer patients
Autor: | Samantha Hassid, Yasemin Karaca, Sven Saussez, Fabrice Journe, Christine Decaestecker, Mohammad Khalife, Denis Larsimont, Myriam Remmelink, Guy Andry, Alexandra Rodriguez, Jerome R. Lechien, Géraldine Descamps, Nadège Kindt |
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Rok vydání: | 2016 |
Předmět: |
0301 basic medicine
Oncology Male Cancer Research Survival Original Article – Clinical Oncology Head and neck cancers 0302 clinical medicine Papillomaviridae Young adult Aged 80 and over Concomitant chemoradiotherapy education.field_of_study Hematology Paraffin Embedding biology Smoking HPV infection General Medicine Chemoradiotherapy Middle Aged Head and Neck Neoplasms 030220 oncology & carcinogenesis Carcinoma Squamous Cell Female Alcohol Adult medicine.medical_specialty HPV Alcohol Drinking Population 03 medical and health sciences Young Adult Internal medicine Tobacco medicine Humans education Aged business.industry Squamous Cell Carcinoma of Head and Neck Head and neck cancer Papillomavirus Infections medicine.disease biology.organism_classification Head and neck squamous-cell carcinoma Cancérologie stomatognathic diseases 030104 developmental biology DNA Viral Neoplasm Recurrence Local business |
Zdroj: | Journal of Cancer Research and Clinical Oncology Journal of cancer research and clinical oncology, 142 (10 |
ISSN: | 1432-1335 |
Popis: | Purpose: Despite the advent of concomitant chemoradiotherapy (CCRT), the prognosis of advanced head and neck squamous cell carcinoma (HNSCC) patients remains particularly poor. Classically, HNSCC, especially oropharyngeal carcinomas, associated with human papillomavirus (HPV) exhibits better treatment outcomes than HNSCCs in non-infected patients, eliciting a call for the de-escalation of current therapies. To improve the management of HNSCC patients, we aimed to determine the impact of active HPV infection on patient response, recurrence and survival after CCRT in a population of heavy tobacco and alcohol consumers. Methods: Paraffin-embedded samples from 218 advanced HNSCC patients, mostly smokers and/or drinkers treated by CCRT, were tested for the presence of HPV DNA by surrogate type-specific E6/E7 qPCR and p16 immunohistochemistry. Associations between the response to CCRT and patient outcomes according to HPV status and clinical data were evaluated by Kaplan–Meier analysis and both univariate and multivariate Cox regression. Results: Type-specific E6/E7 PCR demonstrated HPV positivity in 20 % of HNSCC. Regarding HPV status, we did not find any significant relation with response to therapy in terms of progression-free survival or overall survival. However, we observed a significantly worse prognosis for consumers of alcohol and tobacco compared to nondrinkers (p = 0.003) and non-smokers (p = 0.03). Survival analyses also revealed that the outcome is compromised in stage IV patients (p = 0.007) and, in particular, for oral cavity, hypopharynx and oropharynx carcinoma patients (p = 0.001). Conclusion: The risk of death from HNSCC significantly increases when patients are exposed to tobacco and alcohol during their therapy, regardless of HPV status. SCOPUS: ar.j info:eu-repo/semantics/published |
Databáze: | OpenAIRE |
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