Kara S Davis1, John A Vargo2, Robert L Ferris3, Steven A Burton2, James P Ohr4, David A Clump2, Dwight E Heron2. 1. University of Pittsburgh Medical Center, Department of Otolaryngology - Head and Neck Surgery, Pittsburgh, PA, USA. Electronic address: davisks@upmc.edu. 2. University of Pittsburgh Medical Center, Department of Radiation Oncology, Pittsburgh, PA, USA. 3. University of Pittsburgh Medical Center, Department of Otolaryngology - Head and Neck Surgery, Pittsburgh, PA, USA. 4. UPMC Cancer Center, Medical Oncology, Pittsburgh, PA, USA.
Abstract
PURPOSE: HPV status and smoking history stratifies patients into 3 distinct risk groups for survival following definitive chemoradiotherapy. Local-regional recurrences are common patterns of failure across all 3 risk-groups. SBRT±cetuximab has emerged as a promising salvage strategy for unresectable locally-recurrent, previously-irradiated head-and-neck cancer (rHNC) relative to conventional re-irradiation±chemotherapy. However the influence of HPV and smoking remains unknown in the setting of re-irradiation. METHODS/MATERIALS: Patients (n=30) with rHNC of the oropharynx salvaged with SBRT±cetuximab from August 2002 through August 2013 were retrospectively reviewed; HPV status was determined based on p16 staining of primary pathology. RESULTS: At a median follow-up of 10months for surviving patients, the mean overall survival for all patients was 12.6 months. HPV positivity was a significant predictor of overall survival (13.6 vs. 6.88 months, p=0.024), while smoking status did not significantly impact overall survival (p=0.707). CONCLUSION: HPV status remains a significant predictor of overall survival in the re-irradiation setting with HPV positive rHNC demonstrating superior overall survival following salvage SBRT±cetuximab.
PURPOSE:HPV status and smoking history stratifies patients into 3 distinct risk groups for survival following definitive chemoradiotherapy. Local-regional recurrences are common patterns of failure across all 3 risk-groups. SBRT±cetuximab has emerged as a promising salvage strategy for unresectable locally-recurrent, previously-irradiated head-and-neck cancer (rHNC) relative to conventional re-irradiation±chemotherapy. However the influence of HPV and smoking remains unknown in the setting of re-irradiation. METHODS/MATERIALS: Patients (n=30) with rHNC of the oropharynx salvaged with SBRT±cetuximab from August 2002 through August 2013 were retrospectively reviewed; HPV status was determined based on p16 staining of primary pathology. RESULTS: At a median follow-up of 10months for surviving patients, the mean overall survival for all patients was 12.6 months. HPV positivity was a significant predictor of overall survival (13.6 vs. 6.88 months, p=0.024), while smoking status did not significantly impact overall survival (p=0.707). CONCLUSION:HPV status remains a significant predictor of overall survival in the re-irradiation setting with HPV positive rHNC demonstrating superior overall survival following salvage SBRT±cetuximab.
Authors: Carole Fakhry; Qiang Zhang; Phuc Felix Nguyen-Tan; David Rosenthal; Adel El-Naggar; Adam S Garden; Denis Soulieres; Andy Trotti; Vilija Avizonis; John Andrew Ridge; Jonathan Harris; Quynh-Thu Le; Maura Gillison Journal: J Clin Oncol Date: 2014-06-23 Impact factor: 44.544
Authors: Jessica H Maxwell; Bhavna Kumar; Felix Y Feng; Francis P Worden; Julia S Lee; Avraham Eisbruch; Gregory T Wolf; Mark E Prince; Jeffrey S Moyer; Theodoros N Teknos; Douglas B Chepeha; Jonathan B McHugh; Susan G Urba; Jay Stoerker; Heather M Walline; David M Kurnit; Kitrina G Cordell; Samantha J Davis; Preston D Ward; Carol R Bradford; Thomas E Carey Journal: Clin Cancer Res Date: 2010-02-09 Impact factor: 12.531
Authors: Robin Williams; Dong Wook Lee; Bennett D Elzey; Mary E Anderson; Bruce S Hostager; John H Lee Journal: Head Neck Date: 2009-07 Impact factor: 3.147
Authors: Francis P Worden; Bhavna Kumar; Julia S Lee; Gregory T Wolf; Kitrina G Cordell; Jeremy M G Taylor; Susan G Urba; Avraham Eisbruch; Theodoros N Teknos; Douglas B Chepeha; Mark E Prince; Christina I Tsien; Nisha J D'Silva; Kun Yang; David M Kurnit; Heidi L Mason; Tamara H Miller; Nancy E Wallace; Carol R Bradford; Thomas E Carey Journal: J Clin Oncol Date: 2008-05-12 Impact factor: 44.544
Authors: Harriët C Hafkamp; J J Manni; A Haesevoets; A C Voogd; M Schepers; F J Bot; A H N Hopman; F C S Ramaekers; Ernst-Jan M Speel Journal: Int J Cancer Date: 2008-06-15 Impact factor: 7.396
Authors: William C Spanos; Paul Nowicki; Dong Wook Lee; Andrew Hoover; Bruce Hostager; Anjali Gupta; Mary E Anderson; John H Lee Journal: Arch Otolaryngol Head Neck Surg Date: 2009-11
Authors: Dwight E Heron; Robert L Ferris; Michalis Karamouzis; Regiane S Andrade; Erin L Deeb; Steven Burton; William E Gooding; Barton F Branstetter; James M Mountz; Jonas T Johnson; Athanassios Argiris; Jennifer R Grandis; Stephen Y Lai Journal: Int J Radiat Oncol Biol Phys Date: 2009-05-21 Impact factor: 7.038
Authors: Alexander Rühle; Tanja Sprave; Tobias Kalckreuth; Raluca Stoian; Erik Haehl; Constantinos Zamboglou; Roland Laszig; Andreas Knopf; Anca-Ligia Grosu; Nils H Nicolay Journal: Radiat Oncol Date: 2020-04-16 Impact factor: 3.481