EVALUATION OF TOXICITY PROFILE AND PROGNOSIS OF TREATMENT OF HPV ASSOCIATED HEAD AND NECK SQUAMOUS CELL CARCINOMA (HNSCC), WITH CHEMORADIOTHERAPY
Abstract
Head and Neck cancer is generally referred as squamous cell carcinoma of Head and Neck and are located at the oral or nasal cavity. It has been one of the leading cause of death around the globe and has significantly increased epidemiological growth and rate of mortality over the last three decades. A significant subset of the 600,000 annual cases of HNSCC includes approximately 85,000 HPV associated (oropharyngeal) tumors, which means that the head and neck region is the second most common HPV+ tumor site. In 90% of the HPV associated tumors, HPV16 detection can be seen. The objective of the proposed study is to evaluate the effects of chemoradiotherapy and its toxicity profile for the treatment of HPV negative and HPV positive carcinomas. In a case-control study, 100 patients were enrolled and grouped into two groups with HPV negative and HPV positive carcinogenic tumor in the ratio of 50:50. All the patients are exposed to the treatment with concurrent chemoradiotherapy and radiotherapy. From the study, it can be concluded that HPV- positive tumors have less cumulative exposure to multiple risk factors (tobacco chewing, alcohol, smoking). The association of tumor HPV status with treatment response observed in our study showed a trend of better treatment outcome, consistent in the design and analysis of current and future clinical trials of treatments for head and neck cancer patients.
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References
2. Marur S, Forastiere AA. Head and Neck Squamous Cell Carcinoma: Update on Epidemiology, Diagnosis, and Treatment. Mayo Clin Proc. 2016;91(3):386-396.
doi:10.1016/j.mayocp.2015.12.017
3. Argiris A, Karamouzis M V, Raben D, Ferris RL. Head and neck cancer. Lancet (London, England). 2008;371(9625):1695-1709. doi:10.1016/S0140-6736(08)60728-X
4. Pisani P, Parkin DM, Bray F, Ferlay J. Estimates of the worldwide mortality from 25 cancers in 1990. Int J Cancer. 1999;83(1):18-29. doi:10.1002/(SICI)1097-0215(19990924)83:1<18::AIDIJC5>3.0.CO;2-M
5. Feller L, Wood NH, Khammissa RA, Lemmer J. Human papillomavirusmediated carcinogenesis and HPVassociated oral and oropharyngeal squamous cell carcinoma. Part 1: Human papillomavirus-mediated carcinogenesis. Head Face Med. 2010;6(1):14. doi:10.1186/1746-160X-6-14
6. Chaturvedi P, Chocolatewala N. Role of human papillomavirus in the oral carcinogenesis: An Indian perspective. J Cancer Res Ther. 2009;5(2):71. doi:10.4103/0973-1482.52788
7. Junior JE, Giraldo PC, Cavalcante DI, Goncalves AK, Eleuterio RM. Association between high-risk HPV viral load, p16ink4a expression, and intraepithelial cervical lesions. Rev Assoc Med Bras. 2007;53(6):530-534. doi:S0104-42302007000600022 [pii]
8. Lesnikova I, Lidang M, Hamilton-Dutoit S, Koch J. P16 as a diagnostic marker of cervical neoplasia: A tissue microarray study of 796 archival specimens. Diagn
Pathol. 2009;4(1). doi:10.1186/1746-1596-4-22
9. Chan a T, Leung SF, Chau RM, Yu PK, King WW, Johnson PJ. Increased incidence of tongue cancer after primary radiotherapy for nasopharyngeal carcinoma--the possibility of radiation carcinogenesis. Eur J Cancer. 1999;35(2):219-225. doi:http://dx.doi.org/10.1016/S0959-8049%2898%2900386-4
10. Committee O behalf of the AJC on C (AJCC) MS, Gershenwald JE, Soong S, Balch CM. 2010 TNM Staging System for Cutaneous Melanoma…and Beyond. Ann Surg Oncol. 2010;17(6):1475-1477. doi:10.1245/s10434-010-0986-3
11. Stephen JK, Divine G, Chen KM, Chitale D, Havard S, Worsham MJ. The significance of p16 in site-specific HPV positive and HPV negative HNSCC. Cancer Clin Oncol. 2012;2(1). doi:10.5539/cco.v2n1p51
12. Kanao H, Enomoto T, Ueda Y, et al. Correlation between p14ARF/p16INK4A expression and HPV infection in uterine cervical cancer. Cancer Lett. 2004;213(1):31-37. doi:10.1016/j.canlet.2004.03.030
13. Mirimanoff RO. Concurrent chemotherapy (CT) and radiotherapy (RT) in locally advanced non-small cell lung cancer (NSCLC): a review. Lung Cancer. 1994;11(SUPPL. 3). doi:10.1016/0169-5002(94)91869-4
14. Dok R, Kalev P, Van Limbergen EJ, et al. P16INpK4a impairs homologous recombination-mediated DNA repair in human papillomavirus-positive head and
neck tumors. Cancer Res. 2014;74(6):1739-1751. sdoi:10.1158/0008-5472.CAN-13-2479
