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
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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