Patients with HPV-Positive Throat Cancers More Likely to Make Complete Recovery without Surgery
At the ASTRO 2014 Annual Meeting, Fox Chase radiation oncologist Thomas Galloway, MD, presented a study showing that patients with human papillomavirus (HPV)–positive oropharyngeal cancer see significantly higher rates of complete response on a post-radiation neck dissection than those without HPV.
After radiation and chemotherapy, many head and neck cancer patients still have persistent lumps in their neck, albeit often smaller than when they were first diagnosed. Because surgery to remove these lumps can cause neck and shoulder problems and difficulty swallowing, Galloway’s team wanted to see if removing the lumps was necessary or if it was safe to let them dissolve on their own.
“Accurately defining which patients have achieved a complete response prior to surgery is of paramount importance,” says Galloway, director of clinical research and lead author on the study.
The team reviewed medical records from 396 patients whose oropharyngeal tumors had spread to at least one lymph node. Within 180 days after completing radiation therapy, 146 patients underwent neck surgery. For 99 patients, their records indicated whether or not their tumors had likely been triggered by HPV. Galloway and his team found that HPV-positive patients’ cancers were less likely to recur, regardless of whether or not the tumors had completely disappeared following treatment. In fact, patients’ HPV status was the strongest predictor of survival to the end of the study.
Among the patients who underwent neck surgery, any lingering lumps were more likely to be benign in patients with HPV, either becoming permanent scars or eventually disappearing.
Currently, it is not routine to consider a patient’s HPV status when deciding whether to perform neck surgery. These findings suggest that perhaps it should be.
This study was supported by a Radiation Therapy Oncology Group and Community Clinical Oncology Program grant from the National Cancer Institute.
Ma Named ASTRO Fellow
C.M. Charlie Ma, PhD, Fox Chase professor, vice chair of radiation oncology, and director of radiation physics, was named an ASTRO Fellow at the organization’s 56th Annual Meeting. The Fellows Program honors leaders in radiation oncology who have contributed at least 10 years of service to ASTRO and had a substantial impact on the field through their research, leadership, patient care, and education.