Oropharyngeal Squamous Cell Carcinoma Treated With Radiotherapy or Radiochemotherapy: Prognostic Role of TP53 and HPV Status

Journal Article · Sun Nov 15 04:00:00 EST 2009 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2008.12.088· OSTI ID:21367500

Fallai, Carlo ^[1]; Perrone, Federica ^[2]; Licitra, Lisa ^[3]; Pilotti, Silvana ^[2]; Locati, Laura; Bossi, Paolo ^[3]; Orlandi, Ester; Palazzi, Mauro; Olmi, Patrizia ^[1]

---

1. Radiation Oncology Department, Fondazione IRCCS, Istituto Nazionale Tumori, Milan (Italy)
2. Pathology Department, Fondazione IRCCS, Istituto Nazionale Tumori, Milan (Italy)
3. Medical Oncology Department, Fondazione IRCCS, Istituto Nazionale Tumori, Milan (Italy)

Purpose: To study the prognostic value of the TP53 mutation and human papilloma virus (HPV) status in oropharyngeal squamous cell carcinoma (OPSCC). Methods and materials: The TP53 mutation and HPV status were analyzed in 78 cases of locoregionally advanced OPSCC. The possible correlation of these factors with locoregiownal control, relapse-free survival, disease-specific survival, and overall survival (OS) was also investigated. Results: Of these 78 cases, 22 had disruptive and 22 had non-disruptive (silent) TP53 mutations; the remaining 34 cases had wild-type (WT) TP53. HPV 16 DNA was found in 9 cases (11%), but all HPV-positive (HPV+) cases carried a functional p53 protein, except for 1 case that had a silent mutation. HPV+ patients fared better than HPV-negative (HPV-) patients in terms of all survival parameters, with highly statistically significant differences between the groups. Specifically, no distant metastases were observed in the HPV+ patients, whereas they occurred in 17% of the HPV- patients. However, no difference was observed between the WT TP53 and mutation group, even when this was analyzed in terms of disruptive and non-disruptive mutations. Regardless, treatment with chemotherapy nearly doubled the 5-year OS rates, both in the mutation (42% vs. 22%) and WT (30 vs. 16%) group, but only the mutation group showed improvement in all survival parameters. In addition, the second tumor-free 5-year survival rate was 72% in HPV- cases, but no second tumors were observed in HPV+ and WT p53 cases. Conclusions: Patients with HPV+ OPSCC have an excellent prognosis after radiochemotherapy, but cisplatin-based chemotherapy may not confer a satisfactory outcome, especially in WT cases, thereby justifying the additional or alternative use of taxanes and epidermal growth factor receptors inhibitors. Uncommon distant metastases and second tumors in the HPV+ group may be cause for clinicians to review the follow-up policies in these patients.

• OSTI ID: 21367500
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 4 Vol. 75; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BODY
CARCINOMAS
CHEMOTHERAPY
DIGESTIVE SYSTEM
DISEASES
GROWTH FACTORS
MEDICINE
MEMBRANE PROTEINS
METASTASES
MITOGENS
MUTATIONS
NEOPLASMS
NUCLEAR MEDICINE
ORGANIC COMPOUNDS
ORGANS
PHARYNX
PROTEINS
RADIOLOGY
RADIOTHERAPY
RECEPTORS
RESPIRATORY SYSTEM
THERAPY