Skip to main content
SpringerLink
Log in

Survival of patients with HPV-positive oropharyngeal cancer after radiochemotherapy is significantly enhanced

Das Überleben von Patienten mit HPV positivem Oropharynxkarzinom nach Radiochemotherapie ist signifikant erhöht

  • Original Article
  • Published:
Wiener klinische Wochenschrift Aims and scope Submit manuscript

Zusammenfassung

HINTERGRUND: Der Zweck dieser retrospektiven Studie war, die Inzidenz und klinische Signifikanz von Infektionen mit HPV (Humanes Papillomavirus) in Patienten mit Kopf-Hals-Tumoren, die eine Strahlentherapie erhalten hatten, zu evaluieren. PATIENTEN AND METHODEN: Bei 88 Patienten mit Karzinomen des Kopf-Hals-Bereiches wurde eine Untersuchung zur Identifizierung von high-risk HPV mittels Immunhistochemie, PCR (Polymerase Chain Reaction) und in-situ Hybridisierung durchgeführt. 26 Patienten hatten ein Karzinom der Mundhöhle, 45 des Oropharynx, sieben ein Larynx- und 10 ein Hypopharnyxkarzinom. 29 der 45 Patienten mit einem Plattenepithelkarzinom des Oropharynx erhielten entweder eine alleinige Strahlentherapie oder eine Kombination mit Cisplatin oder Cetuximab. ERGEBNISSE: Von den 29 untersuchten Patienten, die zur Therapie ihres Oropharynxkarzinoms eine konservative Therapie erhielten, hatten 11 Patienten einen HPV positiven und 18 einen HPV negativen Tumor. Den Patienten wurde eine Strahlentherapie ± Cisplatin oder Cetuximab verabreicht, wobei die Patienten mit einem HPV positiven Tumor ein signifikant besseres Ansprechen auf die Therapie zeigten (p = 0.015). Auch das krankheits-spezifische Überleben war deutlich besser in HPV positiven Patienten (p = 0.001). SCHLUSSFOLGERUNG: Patienten mit einem Oropharynxkarzinom und einem positiven HPV Status sprechen deutlich besser auf eine Radiochemotherapie an als Patienten mit einem HPV negativen Tumor. Das HPV Screening ist eine sehr einfache Prozedur und kann einfach routinemässig in die Standard Operational Procedures inkludiert werden.

Summary

BACKGROUND: The purpose of this study was to evaluate the incidence and clinical significance of HPV (Human papilloma virus) infection in patients with head and neck cancer who had received radiotherapy in Eastern Austria. PATIENTS AND METHODS: 88 patients with head and neck cancer including 26 patients with oral cavity cancer, 45 patients with oropharyngeal cancer, seven patients with laryngeal carcinoma and ten patients with carcinoma of the hypopharynx were screened for high risk HPV by immunohistochemistry, PCR (Polymerase Chain Reaction) and in-situ hybridization. 29 out of 45 patients with a squamous cell carcinoma of the oropharynx received radiotherapy alone, radiotherapy in combination with cisplatin or cetuximab. RESULTS: Of the investigated 29 patients with oropharyngeal cancer receiving conservative treatment, 11 had a HPV-positive and 18 a HPV-negative tumor. Patients received radiation ± cisplatin or cetuximab, where the HPV-positive patients had a significant better response to treatment and overall survival (p = 0.015) as well as disease-free survival (p = 0.001) after therapy. CONCLUSION: Patients with oropharyngeal carcinoma and a positive HPV status respond considerably better to radiochemotherapy than patients with HPV-negative tumors. HPV screening is a simple procedure and can easily be implemented in routine pathology investigations and should be included in standard operational procedures for the diagnosis and therapy of head and neck cancer patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  • La Vecchia C, Tavani A, Franceschi S, Levi F, Corrao G, Negri E. Epidemiology and prevention of oral cancer. Oral Oncol 1997;33(5):302–12

    Article  PubMed  CAS  Google Scholar 

  • Lee YC, Marron M, Benhamou S, Bouchardy C, Ahrens W, Pohlabeln H, et al. Active and involuntary tobacco smoking and upper aerodigestive tract cancer risks in a multicenter case-control study. Cancer Epidemiol Biomarkers Prev 2009;18(12):3353–61

    Article  PubMed  CAS  Google Scholar 

  • Shiboski Ch, Schmidt BL, Jordan RC. Tongue and tonsil carcinoma: increasing trends in U.S. population ages 20–44 years. Cancer 2005;103(9):1843-9

    Article  PubMed  Google Scholar 

  • Hammarstedt L, Lindquist D, Dahlstrand H, Romanitan M, Dahlgren LO, Joneberg J, et al. Human papillomavirus as a risk factor for the increase in incidence of tonsillar cancer. Int J Cancer 2006;119(11):2620–3

    Article  PubMed  CAS  Google Scholar 

  • Näsman A, Attner P, Hammarstedt L, Du J, Eriksson M, Giraud G, et al. Incidence of human papillomavirus (HPV) positive tonsillar carcinoma in Stockholm, Sweden: An epidemic of viral-induced carcioma? In J Cancer 2009;125:362–6

    Google Scholar 

  • Marur S, D'Souza G, Westra WH, Forastiere AA. HPV-associated head and neck cancer: a virus-related cancer epidemic. Lancet Oncol 2010 [Ahead of print]

  • Syrjanen S. Human papillomavirus (HPV) in head and neck cancer. J Clin Virol 2005;32 (Suppl. 1):59–66

    Article  Google Scholar 

  • Psyrri A, DiMaio D. Human papillomavirus in cervical and head-and-neck cancer. Nat Clin Pract Oncol 2007;5(1):24–31

    Article  Google Scholar 

  • Puscas L. The role of human papilloma virus infection in the etiology of oropharyngeal carcinoma. Curr Opin Otolaryngol Head Neck Surg 2005;13(4):212–6.

    Article  PubMed  Google Scholar 

  • Xavier SD, Filho IB, Lancellotti CLP. Prevalence of histological findings of human papillomavirus (HPV) in oral and oropharyngeal squamous cell carcinoma biopsies: preliminary study. Braz J Otorhinolaryngol 2005;71(4):510–4

    PubMed  Google Scholar 

  • Begum S, Cao D, Gillison M, Zahurak M, Westra WH. Tissue distribution of human papillomavirus 16 DNA integration in patients with tonsillar carcinoma. Clin Cancer Res 2005;11:5694–9

    Article  PubMed  CAS  Google Scholar 

  • Charfi L, Jouffroy T, de Cremoux P, Peltier N, Thioux M, Fréneaux P, et al. Two types of squamous cell carcinoma of the palatine tonsil characterized by distinct etiology, molecular features and outcome. Cancer Lett 2008;260(1–2):72–8

    Article  PubMed  CAS  Google Scholar 

  • Fahkry C, Gillison ML. Clinical implications of human papillomavirus in head and neck cancer. J Clin Oncol 2006;24(17):2606–11

    Article  Google Scholar 

  • Birner P, Bachtiary B, Dreier B, Schindl M, Joura EA, Breitenecker G, Oberhuber G. Signal-amplified colorimetric in situ hybridization for assessment of human papillomavirus infection in cervical lesions. Mod Pathol 2001;14(7):702–9

    Article  PubMed  CAS  Google Scholar 

  • Fallai C, Perrone F, Licitra L, Pilotti S, Locati L, Bossi P, et al. Oropharyngeal squamous cell carcinoma treated with radiotherapy or radiochemotherapy: prognostic role of TP53 and HPV status. Int J Radiat Oncol Biol Phys 2009;75(4):1053–9

    Article  PubMed  Google Scholar 

  • Fei J, Hong A, Dobbins TA, Jones D, Lee CS, Loo C, et al. Prognostic significance of vascular endothelial growth factor in squamous cell carcinomas of the tonsil in relation to human papillomavirus status and epidermal growth factor receptor. Ann Surg Oncol 2009;16(10):2908–17

    Article  PubMed  Google Scholar 

  • Sedaghat AR, Zhang Z, Begum S, Palermo R, Best S, Ulmer KM, et al. Prognostic significance of human papillomavirus in oropharyngeal squamous cell carcinomas. Laryngoscope 2009;119(8):1542–9

    Article  PubMed  Google Scholar 

  • Nicholas AC, Faquin WC, Westra WH, Mroz EA, Begum S, Clark JR, et al. HPV-16 infection predicts treatment outcome in oropharyngeal squamous cell carcinoma. Otolaryngol Head Neck Surg 2009;140(2):228–34

    Article  Google Scholar 

  • Licitra L, Perrone F, Bossi P, Suardi S, Mariani L, Artusi R, et al. High-risk human papillomavrius affects prognosis in patients with surgically treated oropharyngeal squamous cell carcinoma. J Clin Oncol 2006;24(36):5630–6

    Article  PubMed  CAS  Google Scholar 

  • Munger K, Howley PM. Human papillomavirus immortalization and transformation functions. Virus Res 2002;89:213–28

    Article  PubMed  CAS  Google Scholar 

  • Perrone F, Suardi S, Pastore E, Casieri P, Orsenigo M, Caramuta S, et al. Molecular and cytogenetic subgroups of oropharyngeal squamous cell carcinoma. Clin Cancer Res 2006;12:6643–51

    Article  PubMed  CAS  Google Scholar 

  • Friesland S, Mellin H, Munck-Wikland E, Nilsson A, Lindholm J, Dalianis T, et al. Human papilloma virus (HPV) and p53 immunostaining in advanced tonsillar carcinoma-relation to radiotherapy response and survival. Anticancer Res 2001;21(1B):529–34

    PubMed  CAS  Google Scholar 

  • Dahlstrand H, Dahlgren L, Lindquist D, Munck-Wikland E, Dalianis T. Presence of human papillomavirus in tonsillar cancer is a favourable prognostic factor for clinical outcome. Anticancer Res 2004;24(3b):1829–35

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria

    Claudia Lill, Martin Burian & Dietmar Thurnher

  2. Department of Medicine I and Cancer Center, General Hospital, Medical University of Vienna, Vienna, Austria

    Gabriela Kornek

  3. Department of Radiotherapy, Medical University of Vienna, Vienna, Austria

    Barbara Bachtiary & Edgar Selzer

  4. Department of Maxillofacial Surgery, Medical University of Vienna, Vienna, Austria

    Christian Schopper

  5. Center for Medical Statistic, Informatics, Medical University of Vienna, Vienna, Austria

    Martina Mittlboeck

  6. Department of Pathology, Medical University of Vienna, Vienna, Austria

    Friedrich Wrba

Authors
  1. Claudia Lill
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gabriela Kornek
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Barbara Bachtiary
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Edgar Selzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Christian Schopper
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Martina Mittlboeck
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Martin Burian
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Friedrich Wrba
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Dietmar Thurnher
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dietmar Thurnher.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lill, C., Kornek, G., Bachtiary, B. et al. Survival of patients with HPV-positive oropharyngeal cancer after radiochemotherapy is significantly enhanced. Wien Klin Wochenschr 123, 215–221 (2011). https://doi.org/10.1007/s00508-011-1553-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00508-011-1553-z

Keywords

Search

Navigation