Timo Carpén1, Kauko Saarilahti2, Caj Haglund3,4, Antti Markkola5, Jussi Tarkkanen6, Jaana Hagström4,6, Petri Mattila7, Antti Mäkitie7,8. 1. 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. 2. Department of Oncology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 3. Department of Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 4. Research Program Unit, Translational Cancer Biology, University of Helsinki, Helsinki, Finland. 5. Department of Radiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 6. Department of Pathology, Haartman Institute and HUSLAB, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 7. Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Kasarmikatu 11-13, 00029 HUS, Helsinki, Finland. 8. Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden.
Abstract
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.
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.
Entities:
Keywords:
Human papillomavirus; Marker; Oncology; Radiochemotherapy; Survival
Authors: Joost L Knegjens; Michael Hauptmann; Frank A Pameijer; Alfons J Balm; Frank J Hoebers; Josien A de Bois; Johannes H Kaanders; Carla M van Herpen; Cornelia G Verhoef; Oda B Wijers; Ruud G Wiggenraad; Jan Buter; Coen R Rasch Journal: Head Neck Date: 2011-03 Impact factor: 3.147
Authors: Hisham Mehanna; Tom Beech; Tom Nicholson; Iman El-Hariry; Christopher McConkey; Vinidh Paleri; Sally Roberts Journal: Head Neck Date: 2012-01-20 Impact factor: 3.147
Authors: R Hermans; K Op de beeck; W Van den Bogaert; A Rijnders; L Staelens; M Feron; E Bellon Journal: Int J Radiat Oncol Biol Phys Date: 2001-05-01 Impact factor: 7.038
Authors: Kara S Davis; Chwee Ming Lim; David A Clump; Dwight E Heron; James P Ohr; Seungwon Kim; Umamaheswar Duvvuri; Jonas T Johnson; Robert L Ferris Journal: Head Neck Date: 2015-12-17 Impact factor: 3.147
Authors: Guido B van den Broek; Coen R N Rasch; Frank A Pameijer; Ellen Peter; Michiel W M van den Brekel; I Bing Tan; Jan H Schornagel; Josien A de Bois; Lambert J Zijp; Alfons J M Balm Journal: Cancer Date: 2004-10-15 Impact factor: 6.860
Authors: Gypsyamber D'Souza; Aimee R Kreimer; Raphael Viscidi; Michael Pawlita; Carole Fakhry; Wayne M Koch; William H Westra; Maura L Gillison Journal: N Engl J Med Date: 2007-05-10 Impact factor: 91.245
Authors: Carole Fakhry; William H Westra; Sigui Li; Anthony Cmelak; John A Ridge; Harlan Pinto; Arlene Forastiere; Maura L Gillison Journal: J Natl Cancer Inst Date: 2008-02-12 Impact factor: 13.506
Authors: Gerda M Verduijn; Marta E Capala; Nienke D Sijtsema; Iris Lauwers; Juan A Hernandez Tamames; Wilma D Heemsbergen; Aniel Sewnaik; Jose A Hardillo; Hetty Mast; Yvette van Norden; Maurice P H M Jansen; Aad van der Lugt; Dik C van Gent; Mischa S Hoogeman; Bianca Mostert; Steven F Petit Journal: BMJ Open Date: 2022-05-18 Impact factor: 3.006
Authors: Gabriel Adrian; Henrik Carlsson; Elisabeth Kjellén; Johanna Sjövall; Björn Zackrisson; Per Nilsson; Maria Gebre-Medhin Journal: Radiat Oncol Date: 2022-06-14 Impact factor: 4.309
Authors: Timo Carpén; Stina Syrjänen; Lauri Jouhi; Reija Randen-Brady; Caj Haglund; Antti Mäkitie; Petri S Mattila; Jaana Hagström Journal: Cancer Immunol Immunother Date: 2020-04-20 Impact factor: 6.968
Authors: Olena Klymenko; Anna Maria Stefanie Buchberger; Barbara Wollenberg; Klaus-Dietrich Wolff; Victoria Kehl; Stephanie E Combs; Anja Pickhard; Steffi U Pigorsch Journal: Cancers (Basel) Date: 2021-05-14 Impact factor: 6.639
Authors: Lars Schüttrumpf; Sebastian Marschner; Katrin Scheu; Julia Hess; Sibylle Rietzler; Axel Walch; Philipp Baumeister; Thomas Kirchner; Ute Ganswindt; Horst Zitzelsberger; Claus Belka; Cornelius Maihoefer Journal: Radiat Oncol Date: 2020-01-06 Impact factor: 3.481