Human papillomavirus and induction chemotherapy versus concurrent chemoradiotherapy in locally advanced oropharyngeal cancer: The Dana Farber Experience.

Abstract

Human papillomavirus (HPV) infection indicates favorable prognosis in oropharyngeal squamous cell carcinoma (SCC). The purpose of this study was for us to assess the impact of HPV in patients treated with sequential therapy versus concomitant chemoradiotherapy (CRT). Patients with stage III and IVA and B oropharyngeal SCC were reviewed spanning 10 years. Among 500 cases, 291 (58%) received CRT versus 209 (42%) sequential therapy. HPV status was known in 279 of patients (56%) and positive in 77% (determined by polymerase chain reaction [PCR; 91%], p16 immunohistochemical [IHC], or both). Median follow-up was 2.8 years. Overall survival (OS) did not differ for sequential therapy versus CRT overall (hazard ratio [HR] = 0.90; p = .66; 3-year OS = 86% and 87%) or within HPV-positive patients (HR = 0.89; p = .81; 3-year OS = 91% and 91%) or within HPV-negative patients (HR = 0.55; p = .32; 3-year OS = 85% and 75%). Survival for all patients was high and notable for HPV-negative patients treated with sequential therapy. Further studies in this patient population are warranted. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1618-E1624, 2016.