Clinical Medicine Journal
Articles Information
Clinical Medicine Journal, Vol.2, No.2, Apr. 2016, Pub. Date: Mar. 4, 2016
Prognostic Impact of p16 Alterations and Pretreatment Anemia in Head and Neck Cancer Patients Undergoing Definitive Radiochemotherapy
Pages: 13-19 Views: 1930 Downloads: 686
[01] Martina E. Becker-Schiebe, Department of Radiotherapy and Radio-Oncology, Klinikum Braunschweig, Hannover Medical School, Braunschweig, Germany; Radiation Oncology, Hannover Medical School, Hannover, Germany.
[02] Matthias Sperling, Department of Pathology, Klinikum Braunschweig, Hannover Medical School, Braunschweig, Germany.
[03] Fabian l Wetze, Department of Radiotherapy and Radio-Oncology, Klinikum Braunschweig, Hannover Medical School, Braunschweig, Germany.
[04] Uwe Pinkert, Department of Radiotherapy and Radio-Oncology, Klinikum Braunschweig, Hannover Medical School, Braunschweig, Germany.
[05] Wolfgang Hoffmann, Department of Radiotherapy and Radio-Oncology, Klinikum Braunschweig, Hannover Medical School, Braunschweig, Germany.
Aim: Up to now, the incidence of HPV-associated oropharyngeal cancer is rising, indicating the increased impact of the viral etiology, but prognostic significance of HPV/p16 in other pharyngeal sites remains unclear. In addition, hypoxia might be important for carcinogenesis of head and neck cancer (HNSCC) and treatment response as well. This evaluation was carried out to explore, whether there is any correlation between pretreatment factors like pre-RT anemia and p16 expression and to determine the prognostic value of these factors in advanced HNSCC pts. Methods: A total of 79 locally advanced HNSCC patients (pts.) who underwent definitive RCT- or RT-antibody-therapy were retrospectively analysed. p16 (INK4A) expression was detected by immunohistochemical analysis. Factors predisposing for treatment response were examined and survival curves were compared. Results: The follow-up period ranged from 16 to 48 months, with a median of 25.3 months. Pretreatment anemia was apparent in one third of pts..P16 overexpression was detected in 32 cases. A significant correlation was found between p16 expression and pretreatment hemoglobin level. Only 3 pts. were characterized by both pre-RT anemia and p16 overexpression. Two-year locoregional control, progression-free survival (PFS) and overall survival (OS) were 75%, 62% and 70%, respectively. The prognostic value of p16 in the entire HNSCC patient cohort was confirmed; Kaplan-Meier analysis proved significant differences in progression-free survival (PFS) depending on p16 overexpression and PFS was significantly improved in the non-anemic patient group (p=0.023). In conclusion, this study demonstrated that p16 expression and pretreatment anemia are related to HNSCC subgroups. The prognostic value of this variables was confirmed for a patient cohort consisting of advanced naso-/oro-and hypopharyngeal carcinomas undergoing definitive RCT.
Anemia, p16, Head and Neck Cancer, Radiochemotherapy
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