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Tumor volume as a prognostic marker in p16-positive and p16-negative oropharyngeal cancer patients treated with definitive intensity-modulated radiotherapy.
Carpén, Timo; Saarilahti, Kauko; Haglund, Caj; Markkola, Antti; Tarkkanen, Jussi; Hagström, Jaana; Mattila, Petri; Mäkitie, Antti.
Afiliación
  • Carpén T; Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Kasarmikatu 11-13, 00029 HUS, Helsinki, Finland. timo.carpen@fimnet.fi.
  • Saarilahti K; Department of Oncology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
  • Haglund C; Department of Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
  • Markkola A; Research Program Unit, Translational Cancer Biology, University of Helsinki, Helsinki, Finland.
  • Tarkkanen J; Department of Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
  • Hagström J; Department of Pathology, Haartman Institute and HUSLAB, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
  • Mattila P; Research Program Unit, Translational Cancer Biology, University of Helsinki, Helsinki, Finland.
  • Mäkitie A; Department of Pathology, Haartman Institute and HUSLAB, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Strahlenther Onkol ; 194(8): 759-770, 2018 08.
Article en En | MEDLINE | ID: mdl-29774396
PURPOSE: To investigate the impact of primary gross tumor volume (pGTV) and nodal gross tumor volume (nGTV) in oropharyngeal squamous cell carcinoma (OPSCC) and the difference in their role between human papillomavirus (HPV)-positive and HPV-negative patients. METHODS: The patient cohort consists of 91 OPSCC patients treated with definitive radiochemotherapy or radiotherapy using intensity-modulated radiotherapy (IMRT). All patients had a minimum follow-up of 31 months. Volume measurements were made from computer tomography (CT) scans and HPV status was assessed by p16 immunohistochemistry. The end points were as follows: overall survival (OS), disease-free survival (DFS) and locoregional control (LRC). RESULTS: pGTV was a significant independent prognostic factor for overall survival (OS; p = 0.020) in p16-negative patients. nGTV of p16-negative tumors had significant prognostic value in all end points in multivariate analyses. High-stage (III-IVc) p16-negative tumors were only associated with significantly poorer OS (p = 0.046) but not with poorer LRC or DFS when compared with the low-stage (I-II) tumors. nGTV of p16-positive tumors was an independent prognostic factor for DFS (p = 0.005) and LRC (p = 0.007) in multivariate analyses. CONCLUSION: pGTV may serve as an independent prognostic factor in p16-negative patients and nGTV may serve as an independent prognostic factor both in p16-positive and p16-negative patients treated with radiochemotherapy or radiotherapy using IMRT. Tumor volume may have an impact on selecting patients for de-escalation protocols in the future, both in p16-positive and p16-negative patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Orofaríngeas / Biomarcadores de Tumor / Infecciones por Papillomavirus / Carga Tumoral / Papillomavirus Humano 16 / Radioterapia de Intensidad Modulada Tipo de estudio: Prognostic_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Strahlenther Onkol Asunto de la revista: NEOPLASIAS / RADIOTERAPIA Año: 2018 Tipo del documento: Article País de afiliación: Finlandia Pais de publicación: Alemania
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Orofaríngeas / Biomarcadores de Tumor / Infecciones por Papillomavirus / Carga Tumoral / Papillomavirus Humano 16 / Radioterapia de Intensidad Modulada Tipo de estudio: Prognostic_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Strahlenther Onkol Asunto de la revista: NEOPLASIAS / RADIOTERAPIA Año: 2018 Tipo del documento: Article País de afiliación: Finlandia Pais de publicación: Alemania