Study: Recurrence of SCCOP may differ in HPV-positive and HPV-negative patients

Source: News MedicalPublished: February 21, 2014  Patients 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 [...]