Navigation Links
HPV-positive SCCOP patients' recurrence differs from HPV-negative patients
Date:2/20/2014

Scottsdale, Ariz., February 20, 2014Patients with HPV-positive squamous cell carcinoma of the oropharynx (SCCOP) had a longer time to development of distant metastasis (DM) after initial treatment, and had more metastatic sites in more atypical locations compared to HPV-negative patients, according to research presented today at the 2014 Multidisciplinary Head and Neck Cancer Symposium.

Culled from records of an IRB-approved registry, the study reviewed 285 patients with stage III-IV SCCOP (originally thought to be a smoking-related head and neck cancer) treated with chemotherapy and radiation from 2002 to 2013. HPV status was determined by in situ hybridization for HPV DNA and/or by strong and diffuse (>75 percent) staining for p16 immunohistochemistry. There were 245 HPV-positive and 40 HPV-negative patients.

Twenty-seven HPV-positive and eight HPV-negative patients failed with DM and were the subjects for more detailed evaluation. Radiation therapy (RT) was either 3-D RT (HPV-positive = 15/27; HPV-negative = 4/8) or intensity modulated radiation therapy (IMRT) (HPV-positive = 12/27; HPV-negative = 4/8) with doses from 66-79 Gy. Patients received concurrent chemotherapy of cisplatin (HPV-positive = 9/27; HPV-negative = 2/8), cisplatin/5 fluorouracil (FU) (HPV-positive = 10/27; HPV-negative = 3/8) or cetuximab (HPV-positive = 8/27; HPV-negative = 2/8). One HPV-negative patient received cisplatin/paclitaxel chemotherapy. One patient in each group was treated with adjuvant chemoradiotherapy after initial resection. Student t-tests were used to compare the difference between the means of the samples.

Both HPV-positive and HPV-negative patients were found to have similar rates of DM, however the mean time to develop DM was significantly longer for HPV-positive patients (HPV-positive = 21.6 months vs. HPV-negative = 7.0 months). The most common sites of metastasis for all patients were the lung (HPV-positive = 17/27 vs. HPV-negative = 5/8) and bone (HPV-positive = 12/27 vs. HPV-negative = 2/8). The average number of metastatic subsites was significantly higher for HPV-positive patients (HPV-positive = 2.0 vs. HPV-negative = 1.1, p = 0.026). Twenty-one of 27 HPV-positive patients had more than one metastatic deposit, and 12/27 had DM involving more than one organ system, compared to only 1/8 for HPV-negative patients. Metastases in less typical sites were more common in HPV-positive patients; sites included the liver (6), intra-abdominal lymph nodes (3), brain (2), pleura (2) and peritoneum (1). Locoregional failure (metastases in the original tumor region) was only seen in four of the 27 HPV-positive patients, compared to three of the eight HPV-negative patients.

"The late onset of DM in HPV-positive patients (almost two years) is unusual since the majority of aerodigestive tract malignancies tend to recur within 12-18 months of definitive treatment. The multiple and varied DM sites, which can present as distal localized pain, indicates that we may need to be more aggressive in working up suspicions for metastatic disease and that imaging such as PET/CT scans may be warranted even several years after treatment," said Samuel Trosman, MD, a resident in otolaryngology at the Cleveland Clinic. "We were able to learn significant characteristics of HPV-positive SCCOP that will help us provide more tailored care and surveillance strategies for these patients."


'/>"/>
Contact: Michelle Kirkwood
michellek@astro.org
703-286-1600
American Society for Radiation Oncology
Source:Eurekalert

Related medicine news :

1. Researchers investigate a less toxic radiation treatment for HPV-Positive oropharynx cancer
2. Feasible, safe to limit radiation to major salivary glands in head and neck cancer patients
3. Patients with oropharyngeal cancer report quality of voice and speech affected post-treatment
4. MATH, HPV status in HNSCC patients effective markers of improved patient outcome
5. Researchers look for culprit behind oral health problems in HIV-positive patients
6. Hypnosis therapy shown to decrease fatigue levels in breast cancer patients
7. Bevacizumab (Avastin) fails to improve survival for newly diagnosed glioblastoma patients
8. Blood test serves as crystal ball for heart transplant patients, UCLA-led study finds
9. New treatment proposed to prevent intestinal inflammation in cancer patients
10. One-quarter of high risk patients denied anticoagulation after AF ablation
11. Transgender patients discriminated against for health care services
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:4/28/2016)... Thousand Oaks, CA (PRWEB) , ... April 28, 2016 , ... ... brand is currently number one in Central America and is looking to grow their ... provide marketing for such an exceptional brand as La Sirena Foods and ...
(Date:4/28/2016)... ... April 28, 2016 , ... Head Over Heels Athletic Arts’ gymnast, ... The competition will be held at the University of Montana on April 28-May 1. ... the Mississippi River. , In order to qualify, Varize needed to place top seven ...
(Date:4/28/2016)... ... April 28, 2016 , ... ... open availability of a new CDISC standard, Clinical Trial Registry (CTR) XML. ... This innovative standard will make it possible to build applications that generate ...
(Date:4/28/2016)... ... April 28, 2016 , ... Cosmetic Town, an online plastic surgery ... The forum section was recently revamped and upgraded to allow even more interaction between ... across the country. , According to the senior editor of Cosmetic Town, “We are ...
(Date:4/28/2016)... Beach, FL (PRWEB) , ... April 28, 2016 , ... ... the spring season. Smart pots are frequently used by professional organic farmers and nurseries ... growers to order their supply of fabric pots. Our goal is to offer wholesale ...
Breaking Medicine News(10 mins):
(Date:4/27/2016)... April 27, 2016 ... the  "Global Anesthesia Disposables Market 2016-2020"  report ... ) ,The global anesthesia disposables market ... of 4.03% during the period 2016-2020.  ... threat to patients, safety. Organizations like the ...
(Date:4/27/2016)... April 27, 2016 Global  ... 2.14 billion by 2022, according to a new ...      (Logo: http://photos.prnewswire.com/prnh/20150105/723757 ) , ... the efficiency and accuracy delivered by the new ... for novel urinalysis instruments and consumables. For instance, ...
(Date:4/27/2016)... 2016 At the Sachs CEO ... a Phase 2 clinical study of its lead drug ... cochlear implantation (CI) surgery. This large, placebo-controlled, double-blind, phase ... Germany and France . ... the time of surgery. "Despite advances in cochlear implant ...
Breaking Medicine Technology: