Nichols Anthony C, Faquin William C, Westra William H, Mroz Edmund A, Begum Shanaz, Clark John R, Rocco James W
Department of Otology and Laryngology, Massachusetts Eye and Ear Infirmary, Boston, MA, USA.
Otolaryngol Head Neck Surg. 2009 Feb;140(2):228-34. doi: 10.1016/j.otohns.2008.11.025.
To determine if patients with human papillomavirus (HPV)-positive oropharyngeal squamous cell carcinoma (OPSCC) treated with chemoradiation have improved outcomes.
A retrospective search was used to identify patients with OPSCC treated with concurrent chemoradiation. Pretreatment biopsy specimens were tested for HPV-16 infection and p16 expression.
Forty-four patients with OPSCC treated with concurrent chemotherapy and intensity-modulated radiation therapy were identified. Eligibility criteria included a minimum two years of follow-up, or biopsy-proven recurrence. In situ hybridization was applied to archival tumor specimens, with HPV-16-positive status defined as positive staining of tumor cell nuclei. p16 expression was assessed by immunohistochemistry.
Twenty-seven tumors (61%) were positive for HPV-16 and 29 tumors (66%) expressed p16. HPV-16 infection was highly correlated with p16 expression (P < 10(-7)). Three-year disease-free and overall survival for all patients was 66 percent and 79 percent respectively. Patients with tumors infected with HPV-16 had improved overall (OS) and disease-free survival (DFS) after chemoradiation (OS: hazard ratio [HR] = 0.21, P = 0.01; DFS: HR = 0.30, P = 0.02).
Patients with OPSCC tumors that are infected with HPV-16 have improved survival after treatment with concurrent chemoradiation.
确定接受放化疗的人乳头瘤病毒（HPV）阳性口咽鳞状细胞癌（OPSCC）患者的治疗效果是否有所改善。
采用回顾性检索来确定接受同步放化疗的OPSCC患者。对治疗前活检标本进行HPV - 16感染和p16表达检测。
确定了44例接受同步化疗和调强放疗的OPSCC患者。纳入标准包括至少两年的随访或活检证实的复发。对存档肿瘤标本进行原位杂交，HPV - 16阳性状态定义为肿瘤细胞核阳性染色。通过免疫组织化学评估p16表达。
27例肿瘤（61%）HPV - 16呈阳性，29例肿瘤（66%）表达p16。HPV - 16感染与p16表达高度相关（P < 10(-7)）。所有患者的三年无病生存率和总生存率分别为66%和79%。HPV - 16感染的肿瘤患者在放化疗后的总生存率（OS）和无病生存率（DFS）有所提高（OS：风险比[HR] = 0.21，P = 0.01；DFS：HR = 0.30，P = 0.02）。
HPV - 16感染的OPSCC肿瘤患者在接受同步放化疗后生存率提高。
