Prediction of concurrent chemoradiotherapy outcome in advanced oropharyngeal cancer.
Prediction of concurrent chemoradiotherapy outcome in advanced oropharyngeal cancer.
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DOI：
10.3892/ijo.2014.2504
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发表时间：
2014-09
影响因子：
5.2
通讯作者：
Suzuki M
中科院分区：
文献类型：
--
作者：
Hasegawa M;Maeda H;Deng Z;Kiyuna A;Ganaha A;Yamashita Y;Matayoshi S;Agena S;Toita T;Uehara T;Suzuki M
本研究的目的是探讨人乳头瘤病毒(HPV)感染作为同期放化疗(CCRT)反应的预测因子和晚期口咽鳞状细胞癌(OPSCC)患者计划颈淋巴清扫术(PND)的指标。总体而言，39名OPSCC患者(32名男性，7名女性；年龄中位数61岁，范围39-79岁)入选。原发灶和全颈照射高达50.4GY，原发灶和转移性淋巴结进一步增强16.2GY。虽然采用了多种化疗方案，但82.1%的OPSCC患者接受了奈达铂和5-氟尿嘧啶的联合化疗。16例HPV相关性OPSCC经聚合酶链式反应判定为HPVDNA阳性，免疫组化判定为p16INK4a过表达。N3型和N2型患者在CCRT完成后2~3个月接受PND治疗。在单因素分析中，CCRT应答者与无应答者相比，结节分期(N0至N2b)和HPV阳性状态显著降低。与HPV无关的OPSCC患者相比，HPV相关性OPSCC患者的治疗失败时间更长(p=0.040)。HPV相关组和非HPV非相关组的3年TTF分别为81.3%和47.8%。两组患者的无病生存期(DFS)也有显著差异(p=0.042)。HPV相关性OPSCC和HPV非相关性OPSCC患者的3年无瘤生存率分别为93.8%和66.7%。多因素Logistic分析显示，与HPV无关的OPSCC相比，与HPV相关的OPSCC发生TTF事件的风险更低(p=0.041)。因此，除结节阶段外，HPV检测对预测CCRT反应是有用的，特别是在晚期OPSCC。因为接受PND的患者表现出中等的局部控制率，PND是控制晚期HPV无关疾病患者颈部病变的有效手术方法。
The aim of this study was to investigate human papillomavirus (HPV) infection as a predictor of concurrent chemoradiotherapy (CCRT) response and indicator of planned neck dissection (PND) for patients with advanced oropharyngeal squamous cell carcinoma (OPSCC; stage III/IV). Overall, 39 OPSCC patients (32 men, 7 women; median age 61 years, range 39–79 years) were enrolled. The primary lesion and whole neck were irradiated up to 50.4 Gy, and subsequently the primary site and metastatic lymph nodes were boosted with a further 16.2 Gy. Although several chemotherapy regimens were employed, 82.1% of OPSCC patients received the combination of nedaplatin and 5-fluorouracil. HPV-related OPSCC (16 cases) was defined as both HPV DNA-positive status by polymerase chain reaction and p16INK4a overexpression by immunohistochemistry. Patients with N2 and N3 disease received PND 2–3 months after CCRT completion. Compared to non-responders, CCRT responders showed significantly lower nodal stage (N0 to N2b) and HPV-positive status in univariate analysis. Patients with HPV-related OPSCC had longer time to treatment failure (TTF) than those with HPV-unrelated OPSCC (p=0.040). Three-year TTF was 81.3 and 47.8% in the HPV-related and HPV-unrelated groups, respectively. There were also significant differences in disease-free survival (DFS) between the two OPSCC patient groups (p=0.042). Three-year DFS was 93.8 and 66.7% in patients with HPV-related and HPV-unrelated OPSCC, respectively. Multivariate logistic analysis showed a lower risk of TTF event occurrence in HPV-related OPSCC (p=0.041) than in HPV-unrelated OPSCC. Thus, HPV testing in addition to nodal stage was useful for predicting CCRT response, especially in advanced OPSCC. Because patients who received PND showed moderate locoregional control, PND is an effective surgical procedure for controlling neck lesions in patients with advanced HPV-unrelated disease.
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影响因子：
6.4
作者：
Goenka, Anuj;Morris, Luc G. T.;Lee, Nancy Y.
通讯作者：
Lee, Nancy Y.
影响因子：
3.4
作者：
Hillel, Alexander T.;Fakhry, Carole;Ha, Patrick K.
通讯作者：
Ha, Patrick K.
影响因子：
--
作者：
Shonka, David C., Jr.;Shoushtari, Asal N.;Jameson, Mark J.
通讯作者：
Jameson, Mark J.
影响因子：
8.4
作者：
Eisenhauer, E. A.;Therasse, P.;Verweij, J.
通讯作者：
Verweij, J.
DOI：
10.1002/hed.10394
发表时间：
2004-05-01
影响因子：
2.9
作者：
Argiris, A;Stenson, KM;Vokes, EE
通讯作者：
Vokes, EE