Prognostic impact of human papillomavirus status, survivin, and epidermal growth factor receptor expression on survival in patients treated with radiochemotherapy for very advanced nonresectable oropharyngeal cancer

Background The influence of human papillomavirus (HPV) status on survival for patients with very advanced inoperable oropharyngeal SCC treated with radiochemotherapy (RCT) was studied. Methods Patients received either 69.2 Gy with concomitant boost (ccb) or 70 Gy conventionally fractionated (cf), we...

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Published in:Head & neck 2013-09, Vol.35 (9), p.1339-1344
Main Authors: Semrau, Robert, Duerbaum, Helena, Temming, Susanne, Huebbers, Christian, Stenner, Markus, Drebber, Uta, Klussmann, Jens Peter, Müller, Rolf-Peter, Preuss, Simon F.
Format: Article
Language:English
Subjects:
Adult
Aged
Chemoradiotherapy - methods
chemotherapy
Cyclin-Dependent Kinase Inhibitor p16
ErbB Receptors - metabolism
Female
human papillomavirus
Humans
Immunohistochemistry
Inhibitor of Apoptosis Proteins - metabolism
Male
Middle Aged
Neoplasm Proteins - metabolism
oropharyngeal cancer
Oropharyngeal Neoplasms - metabolism
Oropharyngeal Neoplasms - mortality
Oropharyngeal Neoplasms - therapy
Oropharyngeal Neoplasms - virology
Papillomaviridae - isolation & purification
Papillomavirus Infections - metabolism
Papillomavirus Infections - mortality
Papillomavirus Infections - therapy
Papillomavirus Infections - virology
Polymerase Chain Reaction
Prognosis
radiotherapy
Sequence Analysis, DNA
Survival Rate
Survivin
Treatment Outcome
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Summary:Background The influence of human papillomavirus (HPV) status on survival for patients with very advanced inoperable oropharyngeal SCC treated with radiochemotherapy (RCT) was studied. Methods Patients received either 69.2 Gy with concomitant boost (ccb) or 70 Gy conventionally fractionated (cf), weekly paclitaxel 40 mg/m2, and carboplatin area under the concentration–time curve (AUC) 1. Tumor was analyzed for the presence of high‐risk HPV‐DNA using polymerase chain reaction (PCR) and direct DNA sequencing. p16‐expression, survivin, and epidermal growth factor receptor (EGFR) expression were evaluated by immunohistochemistry and influence on survival was calculated. Results Of 52 patients, 25.0% were HPV positive and 75.0% HPV negative. The 2‐year progression‐free survival (PFS) was 70.1% for p16‐positive patients and 37.1% for p16‐negative patients (p = .005). The 3‐year overall survival (OS) rate was 43.9% for all patients and did not significantly differ between the groups. Neither survivin nor EGFR expression influenced PFS or OS significantly. Conclusions HPV status influences PFS in patients with advanced, nonresectable tumor stages but not OS. Additional risk factors seem to have a stronger influence on survival than HPV status. © 2012 Wiley Periodicals, Inc. Head Neck, 2013
ISSN:1043-3074
1097-0347
DOI:10.1002/hed.23126