Abstract
Objective: Although patients with human papillomavirus (HPV)-positive oropharyngeal carcinoma (OC) respond well to radiation therapy and have good prognosis, HPV integration in OC has not yet been fully analyzed. Therefore, we aimed to clarify the correlation between HPV infection or integration and prognosis of OC in a prospective study setting.
Method: From 2006 to 2010, 56 patients with OC participated in the study. All patients were treated with 70 Gy concurrent chemoradiotherapy (CCRT). If OC did not show a partial or complete response at 40-Gy irradiation, radical resection for residual tumor was performed.
Results: A total of 26 patients (46.4%) had HPV-positive OC, and 70% of HPV-16-positive OC cases showed integration with the host genome. Control samples obtained from chronic tonsillitis patients showed 1 of 47 specimens as positive for HPV. Patients with high HPV load also showed E6/E7 mRNA expression. Recurrent-free survival at 3 years was 100% in HPV-positive cases and 88.9% in HPV-negative cases. Cases with HPV integration or E6/E7 mRNA expression tended to respond well to CCRT in spite of advanced tumor extensions.
Conclusion: Although HPV testing is useful for OC, HPV integration or E6/E7 mRNA expression is a more specific marker for predicting a fair response to CCRT and good prognosis. These findings also indicate that HPV plays a key role in the development and extension of OC.
Get full access to this article
View all access options for this article.