Does pretreatment human papillomavirus (HPV) titers predict radiation response and survival outcomes in cancer cervix?--a pilot study.
OBJECTIVE
To evaluate if pretreatment HPV titers in cancer cervix could predict radiation response and survival outcomes.


METHODS
Twenty-one patients of cancer cervix were treated by radiotherapy (RT) alone. HPV titers were estimated using DNA Hybrid Capture II test. Loco-regional response at 1 month of RT--complete or partial response (CR and PR respectively) and survival outcomes--local disease-free (LDFS), disease-free (DFS) and overall (OS) survivals were evaluated against pre- and posttreatment HPV titers.


RESULTS
Pretreatment HPV titers ranged from 0.81 to 3966.10 RLU/cut off (mean +/- SD: 1264.39 +/- 1148.22, median: 1129.98). Of the demographic features evaluated, mean HPV titers were significantly different only for patients achieving CR or PR at completion of RT (mean +/- SD for CR vs. PR: 1616.31 +/- 1146.86 vs. 384.57 +/- 538.80, P = 0.022). HPV titers at end of RT ranged from 0.12 to 487.42 RLU/cut off (mean +/- SD: 37.31 +/- 108.60, median: 2.33). Patients with higher pretreatment HPV titers (>1000 RLU/cutoff) had a higher CR (P = 0.022) and better survival compared to those with < or =1000 RLU/cutoff (LDFS, P = 0.004; DFS, P = 0.005; OS, P = 0.012). At completion of RT, those having > or =99.5% fall in HPV had superior survival outcomes than those with <99.5% reduction (LDFS, P = 0.002; DFS, P = 0.002; OS, P = 0.004).


CONCLUSIONS
Higher pretreatment HPV titers (>1000 RLU/cutoff) could be considered as a predictor of radiotherapy response and survival in cancer cervix. A reduction in these titers to 99.5% of their baseline values at end of radiotherapy is also associated with better survival outcomes.
Datta
Niloy R
NR
Department of Radiotherapy, Regional Cancer Centre, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Rae Barelli Road, Lucknow-226014, India. nrdatta@yahoo.com
Kumar
Piyush
P
Singh
Shalini
S
Gupta
Dinesh
D
Srivastava
Anurita
A
Dhole
Tapankumar N
TN
D001918:Brachytherapy; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy* / Q000821:virology*; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics / Q000254:growth & development*; D030361:Papillomavirus Infections / Q000150:complications / Q000821:virology; D010865:Pilot Projects; D011237:Predictive Value of Tests; D015996:Survival Rate; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000532:radiotherapy* / Q000821:virology*
D004279:DNA, Viral