Improved Survival of Patients With Human Papillomavirus–Positive Head and Neck Squamous Cell Carcinoma in a Prospective Clinical Trial

摘要: Background The improved prognosis for patients with human papillomavirus (HPV) – positive head and neck squamous cell carcinoma (HNSCC) relative to HPV-negative HNSCC observed in retrospective analyses remains be confirmed a prospective clinical trial. Methods We prospectively evaluated the association of tumor HPV status therapeutic response survival among 96 stage III or IV oropharynx larynx who participated an Eastern Cooperative Oncology Group (ECOG) phase II trial received two cycles induction chemotherapy intravenous paclitaxel carboplatin followed by concomitant weekly standard fractionation radiation therapy. presence absence oncogenic types tumors was determined multiplex polymerase chain reaction (PCR) situ hybridization. Two-year overall progression-free HPV-positive were estimated Kaplan Meier analysis. hazard mortality progression vs after adjustment age, ECOG performance status, stage, other covariables use multivariable Cox proportional hazards model. All statistical tests two-sided. Results Genomic DNA 16, 33, 35 located within nuclei 40% (95% confidence interval [CI] = 30% 50%) hybridization PCR. Compared tumors, had higher rates (82% 55%, difference 27%, 95% CI 9.3% 44.7%, P .01) chemoradiation treatment (84% 57%, 9.7% 44.3%, .007). After median follow-up 39.1 months, (2-year [95% 87% 100%] 62% 49% 74%], 33%, 18.6% 47.4%, .005, log-rank test) and, lower risks (hazard ratio [HR] 0.27, 0.10 0.75), death from any cause (HR 0.36, 0.15 0.85) than those tumors. Conclusion For oropharynx, is strongly associated survival.