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Natural course of distant metastases following radiotherapy or chemoradiotherapy in HPV-related oropharyngeal cancer
Ist Teil von
Oral oncology, 2013-01, Vol.49 (1), p.79-85
Ort / Verlag
Kidlington: Elsevier Ltd
Erscheinungsjahr
2013
Quelle
Elsevier ScienceDirect Journals
Beschreibungen/Notizen
Summary Objectives To describe the natural course of distant metastases (DMs) following radiotherapy (RT) or chemoradiotherapy (CRT) in HPV(+) oropharyngeal carcinoma (OPC). Methods OPC treated with RT/CRT from 1/1/2000 to 5/31/2010 were reviewed. The natural course of DM were compared between HPV(+) and HPV(−) cohorts. Results Median follow-up was 3.9 years. The DM rate were similar (11% vs. 15% at 3-years, p = 0.25) between the HPV(+) ( n = 457) vs. the HPV(−) ( n = 167) cases. While almost all (24/25) HPV(−) DM occurred within 2-years following RT (1 was at 2.1 years), 7/54 (13%) of HPV(+) DM were detected beyond 3 years (up to 5.3 years). Disseminating to >2 organs occurred in 18 (33%) HPV(+) vs. none in HPV(−). Post-DM survival rates were 11% vs. 4% at 2-years ( p = 0.02) for the HPV(+) vs. HPV(−) cases respectively. 5/6 HPV(+) with lung oligo-metastasis were still alive with stable disease beyond 2-years after salvage procedures for DM (chemotherapy: 3; surgical resection: 2; radiotherapy: 1). Conclusions Although DM rates are similar, the natural course of HPV(+) DM differs from that of HPV(−) patients: it may occur after a longer interval, often with a “disseminating” phenotype, and a small number may have prolonged survival after salvage for DM.