Abstract
Objectives/Hypothesis: To evaluate the responsiveness of human papillomavirus (HPV) -positive and HPV-negative oropharyngeal cancer to intensity-modulated radiotherapy (IMRT), using axial imaging obtained daily during the course of image-guided radiotherapy (IGRT). Study Design: Observational cohort study with matched-pair analysis of patients irradiated for HPV-positive and HPV-negative oropharygeal cancer. Methods and Materials: Ten patients treated by IMRT to 70 Gy for locally advanced, HPV-positive squamous cell carcinoma of the oropharynx were matched to one HPV-negative control subject by age, gender, performance status, T-category, tumor location, and the use of concurrent chemotherapy. The gross tumor volume (GTV) was delineated on daily IGRT scans obtained via kilovoltage cone-beam computed tomography (CBCT). Mathematical modeling using fitted mixed-effects repeated measure analysis was performed to quantitatively and descriptively assess the trajectory of tumor regression. Results: Patients with HPV-positive tumors experienced a more rapid rate of tumor regression between day 1 of IMRT and the beginning of week 2 (-33% Δ GTV) compared to their counterparts with HPV-negative tumors (-10% Δ GTV), which was statistically significant (p<0.001). During this initial period, the average absolute change in GTV was -22.9 cc/week for HPV-positive tumors and -5.9 cc/week for HPV-negative tumors (p<0.001). After week 2 of IMRT, the rates of GTV regression were comparable between the two groups. Conclusions: HPV-positive oropharyngeal cancers exhibited an enhanced response to radiation, characterized by a dramatically more rapid initial regression than those with HPV-negative tumors. Implications for treatment de-intensification in the context of future clinical trials and the possible mechanisms underlying this increased radiosensitivity will be discussed. Laryngoscope, 2013
| Original language | English (US) |
|---|---|
| Pages (from-to) | 152-157 |
| Number of pages | 6 |
| Journal | Laryngoscope |
| Volume | 123 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2013 |
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Keywords
- head and neck cancer
- Human papillomavirus
- Level of Evidence: 3B
- radiation therapy
- radiosensitivity
- squamous cell carcinoma
ASJC Scopus subject areas
- Otorhinolaryngology
Cite this
Differential response rates to irradiation among patients with human papillomavirus positive and negative oropharyngeal cancer. / Chen, Allen M.; Li, Judy; Beckett, Laurel A; Zhara, Talia; Farwell, D Gregory; Lau, Derick H; Gandour-Edwards, Regina F; Vaughan, Andrew T M; Purdy, James A.
In: Laryngoscope, Vol. 123, No. 1, 01.2013, p. 152-157.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Differential response rates to irradiation among patients with human papillomavirus positive and negative oropharyngeal cancer
AU - Chen, Allen M.
AU - Li, Judy
AU - Beckett, Laurel A
AU - Zhara, Talia
AU - Farwell, D Gregory
AU - Lau, Derick H
AU - Gandour-Edwards, Regina F
AU - Vaughan, Andrew T M
AU - Purdy, James A.
PY - 2013/1
Y1 - 2013/1
N2 - Objectives/Hypothesis: To evaluate the responsiveness of human papillomavirus (HPV) -positive and HPV-negative oropharyngeal cancer to intensity-modulated radiotherapy (IMRT), using axial imaging obtained daily during the course of image-guided radiotherapy (IGRT). Study Design: Observational cohort study with matched-pair analysis of patients irradiated for HPV-positive and HPV-negative oropharygeal cancer. Methods and Materials: Ten patients treated by IMRT to 70 Gy for locally advanced, HPV-positive squamous cell carcinoma of the oropharynx were matched to one HPV-negative control subject by age, gender, performance status, T-category, tumor location, and the use of concurrent chemotherapy. The gross tumor volume (GTV) was delineated on daily IGRT scans obtained via kilovoltage cone-beam computed tomography (CBCT). Mathematical modeling using fitted mixed-effects repeated measure analysis was performed to quantitatively and descriptively assess the trajectory of tumor regression. Results: Patients with HPV-positive tumors experienced a more rapid rate of tumor regression between day 1 of IMRT and the beginning of week 2 (-33% Δ GTV) compared to their counterparts with HPV-negative tumors (-10% Δ GTV), which was statistically significant (p<0.001). During this initial period, the average absolute change in GTV was -22.9 cc/week for HPV-positive tumors and -5.9 cc/week for HPV-negative tumors (p<0.001). After week 2 of IMRT, the rates of GTV regression were comparable between the two groups. Conclusions: HPV-positive oropharyngeal cancers exhibited an enhanced response to radiation, characterized by a dramatically more rapid initial regression than those with HPV-negative tumors. Implications for treatment de-intensification in the context of future clinical trials and the possible mechanisms underlying this increased radiosensitivity will be discussed. Laryngoscope, 2013
AB - Objectives/Hypothesis: To evaluate the responsiveness of human papillomavirus (HPV) -positive and HPV-negative oropharyngeal cancer to intensity-modulated radiotherapy (IMRT), using axial imaging obtained daily during the course of image-guided radiotherapy (IGRT). Study Design: Observational cohort study with matched-pair analysis of patients irradiated for HPV-positive and HPV-negative oropharygeal cancer. Methods and Materials: Ten patients treated by IMRT to 70 Gy for locally advanced, HPV-positive squamous cell carcinoma of the oropharynx were matched to one HPV-negative control subject by age, gender, performance status, T-category, tumor location, and the use of concurrent chemotherapy. The gross tumor volume (GTV) was delineated on daily IGRT scans obtained via kilovoltage cone-beam computed tomography (CBCT). Mathematical modeling using fitted mixed-effects repeated measure analysis was performed to quantitatively and descriptively assess the trajectory of tumor regression. Results: Patients with HPV-positive tumors experienced a more rapid rate of tumor regression between day 1 of IMRT and the beginning of week 2 (-33% Δ GTV) compared to their counterparts with HPV-negative tumors (-10% Δ GTV), which was statistically significant (p<0.001). During this initial period, the average absolute change in GTV was -22.9 cc/week for HPV-positive tumors and -5.9 cc/week for HPV-negative tumors (p<0.001). After week 2 of IMRT, the rates of GTV regression were comparable between the two groups. Conclusions: HPV-positive oropharyngeal cancers exhibited an enhanced response to radiation, characterized by a dramatically more rapid initial regression than those with HPV-negative tumors. Implications for treatment de-intensification in the context of future clinical trials and the possible mechanisms underlying this increased radiosensitivity will be discussed. Laryngoscope, 2013
KW - head and neck cancer
KW - Human papillomavirus
KW - Level of Evidence: 3B
KW - radiation therapy
KW - radiosensitivity
KW - squamous cell carcinoma
UR - http://www.scopus.com/inward/record.url?scp=84871716229&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84871716229&partnerID=8YFLogxK
U2 - 10.1002/lary.23570
DO - 10.1002/lary.23570
M3 - Article
C2 - 23008061
AN - SCOPUS:84871716229
VL - 123
SP - 152
EP - 157
JO - Laryngoscope
JF - Laryngoscope
SN - 0023-852X
IS - 1
ER -