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International Journal of Clinical Oncology
Published in: International Journal of Clinical Oncology 6/2019

01-06-2019 | Human Papillomavirus | Original Article

Radiotherapy alone as a possible de-intensified treatment for human papillomavirus-related locally advanced oropharyngeal squamous cell carcinoma

Authors: Yoshifumi Yamamoto, Norihiko Takemoto, Takahiro Michiba, Yuji Seo, Fumiaki Isohashi, Keisuke Otani, Motoyuki Suzuki, Takashi Fujii, Tadashi Yoshii, Kenji Mitani, Toshimichi Yasui, Hironori Cho, Yasuhiko Tomita, Eiichi Morii, Teruki Teshima, Kazuhiko Ogawa, Hidenori Inohara

Published in: International Journal of Clinical Oncology | Issue 6/2019

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Abstract

Background

Human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) is defined by p16 positivity and/or HPV DNA positivity. Because survival of patients with HPV-related OPSCC after chemoradiotherapy is favorable, a de-intensified treatment is expected to lead to less morbidity while maintaining low mortality. The association of tumor p16 and HPV DNA status with survival after radiotherapy alone remains unknown.

Methods

We retrospectively examined survival of 107 patients with locally advanced OPSCC after radiotherapy alone (n = 43) or chemoradiotherapy (n = 64) with respect to tumor p16 and HPV DNA status, using Cox’s proportional hazard model.

Results

Survival after radiotherapy alone was significantly worse in p16-positive/HPV DNA-negative locally advanced OPSCC than in p16-positive/HPV DNA-positive locally advanced OPSCC. In bivariable analyses that included T category, N category, TNM stage, and smoking history, the survival disadvantage of p16-positive/HPV DNA-negative locally advanced OPSCC remained significant. There was no significant difference in survival after chemoradiotherapy between p16-positive/HPV DNA-positive locally advanced OPSCC and p16-positive/HPV DNA-negative locally advanced OPSCC. Survival in p16-positive/HPV DNA-positive locally advanced OPSCC after radiotherapy alone was similar to that after chemoradiotherapy, which stayed unchanged in bivariable analyses after adjustment of every other covariable. Survival of p16-negative/HPV DNA-negative locally advanced OPSCC was poor irrespective of treatment modality.

Conclusions

Survival in p16-positive locally advanced OPSCC differs depending on HPV DNA status. Radiotherapy alone can serve as a de-intensified treatment for p16-positive/HPV DNA-positive locally advanced OPSCC, but not for p16-positive/HPV DNA-negative locally advanced OPSCC.
Appendix
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Metadata
Title
Radiotherapy alone as a possible de-intensified treatment for human papillomavirus-related locally advanced oropharyngeal squamous cell carcinoma
Authors
Yoshifumi Yamamoto
Norihiko Takemoto
Takahiro Michiba
Yuji Seo
Fumiaki Isohashi
Keisuke Otani
Motoyuki Suzuki
Takashi Fujii
Tadashi Yoshii
Kenji Mitani
Toshimichi Yasui
Hironori Cho
Yasuhiko Tomita
Eiichi Morii
Teruki Teshima
Kazuhiko Ogawa
Hidenori Inohara
Publication date
01-06-2019
Publisher
Springer Singapore
Published in
International Journal of Clinical Oncology / Issue 6/2019
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-019-01394-1

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