ESTRO: HPV Status, Smoking Affect Outcomes in Oropharyngeal Cancer

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(ChemotherapyAdvisor) – Patients with oropharyngeal cancer who are infected with human papilloma virus (HPV) respond better to radiotherapy, without addition of chemotherapy, than HPV-negative patients, according to Danish researchers. This conclusion is based on a paper entitled “HPV, Smoking and RT — Outcome in Advanced OPC Treated without Chemotherapy: Analysis of DAHANCA Patients,” which was presented on May 10 at the annual meeting of the European Society for Radiotherapy and Oncology (ESTRO) in Barcelona, Spain.

The outcomes of 181 patients in the Danish Head and Neck Cancer Group (DAHANCA) database were   investigated. In this database were patients who had been previously treated for advanced oropharyngeal cancer between 1992 and 2005. Investigators administered accelerated radiotherapy (6 fractions, 5 days) together with the radiation sensitizer: nimorazole; no chemotherapy was administered. Tumor biopsies were tested for HPV infection status.

The investigators reported that “out of the 181 patients, 103 had HPV-positive tumors (57%). HPV-positive patients had better control of the tumor at its primary site (81% vs. 48% of HPV-negative patients), disease-specific survival (90% vs. 56%), and overall survival (77% vs. 38%).”

When investigators analyzed the patients' smoking history, they showed that, in patients who were light smokers or never smokers, “the probability of tumor control at its primary site was 91%, disease-specific survival was 96%, and overall survival 90% five years after completion of radiotherapy. In comparison, the corresponding results for HPV-positive, heavy smokers were 77%, 81% and 63% after five years.”

The results, which were surprising, as previous data had demonstrated that HPV can trigger throat cancer, were presented by Pernille Lassen, MD, a resident in medical and radiation oncology and researcher at Aarhus University Hospital, Aarhus, Denmark.

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