Definitive radiation therapy without chemotherapy for human papillomavirus-positive head and neck cancer.

Abstract

To report a single institutional experience with definitive radiation therapy alone for human papillomavirus (HPV)-positive head and neck cancer. A total of 67 patients were treated by radiation therapy alone to a median dose of 70 Gy (range, 66-72 Gy) for squamous cell carcinoma of the head and neck. Paraffin-embedded, formalin-fixed pretreatment tumor tissues were used to establish HPV-positivity using standardized techniques of immunohistochemistry for p16 and polymerase chain reaction for HPV. In all, 23 patients with HPV-positive cancers were identified. With a median follow-up of 28 months (range, 6-85 months), the 3-year actuarial rates of overall survival, locoregional control, and distant metastasis-free survival were 83%, 90%, and 88%, respectively. These findings attest to the exquisite radiosensitivity of HPV-positive head and neck cancer. The clinical outcomes observed from this selected series compare favorably with historical controls treated by more intensive chemoradiotherapy strategies.