Definitive radiation therapy without chemotherapy for human papillomavirus-positive head and neck cancer

Head Neck. 2013 Nov;35(11):1652-6. doi: 10.1002/hed.23209. Epub 2013 Jan 17.

Abstract

Background: To report a single institutional experience with definitive radiation therapy alone for human papillomavirus (HPV)-positive head and neck cancer.

Methods: A total of 67 patients were treated by radiation therapy alone to a median dose of 70 Gy (range, 66-72 Gy) for squamous cell carcinoma of the head and neck. Paraffin-embedded, formalin-fixed pretreatment tumor tissues were used to establish HPV-positivity using standardized techniques of immunohistochemistry for p16 and polymerase chain reaction for HPV.

Results: In all, 23 patients with HPV-positive cancers were identified. With a median follow-up of 28 months (range, 6-85 months), the 3-year actuarial rates of overall survival, locoregional control, and distant metastasis-free survival were 83%, 90%, and 88%, respectively.

Conclusion: These findings attest to the exquisite radiosensitivity of HPV-positive head and neck cancer. The clinical outcomes observed from this selected series compare favorably with historical controls treated by more intensive chemoradiotherapy strategies.

Keywords: head and neck cancer; human papillomavirus; radiation therapy; radiosensitivity; squamous cell carcinoma.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents
  • Biopsy, Needle
  • Carcinoma, Squamous Cell / drug therapy
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / radiotherapy*
  • Carcinoma, Squamous Cell / virology*
  • Cohort Studies
  • DNA, Viral / analysis
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Head and Neck Neoplasms / drug therapy
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / radiotherapy*
  • Head and Neck Neoplasms / virology*
  • Humans
  • Immunohistochemistry
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / pathology*
  • Papillomaviridae / isolation & purification
  • Papillomavirus Infections / diagnosis*
  • Radiotherapy Dosage
  • Radiotherapy, Conformal / methods
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • DNA, Viral