Chemo- and radiotherapy especially effective in HPV-linked oropharyngeal tumors
5/21/2008 web-based article staff HemOncToday.com Induction chemotherapy as a selection method for concurrent chemoradiotherapy was found to be an effective treatment method for advanced oropharyngeal cancer, and better response to the treatment was associated with the presence of human papilloma virus. Previous research into the increasing incidence of oral/oropharyngeal tumors has indicated HPV as an etiologic factor. Although some reports suggest that HPV-positive individuals with these tumors have better outcomes, the reports have not been unanimous. Researchers at the University of Michigan Comprehensive Cancer Center in Ann Arbor tested the efficacy of induction chemotherapy followed by concurrent chemoradiotherapy or surgery/radiotherapy and assessed the effect of HPV on response and outcome. Study design The study included 66 patients (51 men) with stage III to IV squamous cell carcinoma of the oropharynx. Patients were treated with one cycle of cisplatin (100 mg/m2) or carboplatin (AUC 6) as well as 5-fluorouracil (1,000 mg/m2 per day for five days). This regimen was used as a selection method for those eligible for chemoradiotherapy: patients who achieved a greater than 50% response at the primary tumor received chemoradiotherapy. Patients with a complete histologic response were given adjuvant paclitaxel. Pretreatment biopsies of 42 patients were tested for high-risk HPV. Fifty-four of the 66 patients (81%) achieved the 50% response rate and 53 of these patients received chemoradiotherapy. Among those 53 patients, 49 (92%) achieved a complete histologic response with a 73.4% rate of organ preservation. The four-year overall survival rate was 70.4% with a disease-specific survival rate [...]