title: Prognostic impact of human papillomavirus status, survivin, and epidermal growth factor receptor expression on survival in patients treated with radiochemotherapy for very advanced nonresectable oropharyngeal cancer.
abstract: BACKGROUND
  The influence of human papillomavirus (HPV) status on survival for patients with very advanced inoperable oropharyngeal SCC treated with radiochemotherapy (RCT) was studied.
  
  
  METHODS
  Patients received either 69.2 Gy with concomitant boost (ccb) or 70 Gy conventionally fractionated (cf), weekly paclitaxel 40 mg/m(2), and carboplatin area under the concentration-time curve (AUC) 1. Tumor was analyzed for the presence of high-risk HPV-DNA using polymerase chain reaction (PCR) and direct DNA sequencing. p16-expression, survivin, and epidermal growth factor receptor (EGFR) expression were evaluated by immunohistochemistry and influence on survival was calculated.
  
  
  RESULTS
  Of 52 patients, 25.0% were HPV positive and 75.0% HPV negative. The 2-year progression-free survival (PFS) was 70.1% for p16-positive patients and 37.1% for p16-negative patients (p = .005). The 3-year overall survival (OS) rate was 43.9% for all patients and did not significantly differ between the groups. Neither survivin nor EGFR expression influenced PFS or OS significantly.
  
  
  CONCLUSIONS
  HPV status influences PFS in patients with advanced, nonresectable tumor stages but not OS. Additional risk factors seem to have a stronger influence on survival than HPV status.
authors.affiliation: Department of Radiation Oncology, University Hospital of Cologne, Cologne, Germany. Robert.Semrau@uk-koeln.de
authors.forename: Robert
authors.initials: R
authors.lastname: Semrau
authors.forename: Helena
authors.initials: H
authors.lastname: Duerbaum
authors.forename: Susanne
authors.initials: S
authors.lastname: Temming
authors.forename: Christian
authors.initials: C
authors.lastname: Huebbers
authors.forename: Markus
authors.initials: M
authors.lastname: Stenner
authors.forename: Uta
authors.initials: U
authors.lastname: Drebber
authors.forename: Jens Peter
authors.initials: JP
authors.lastname: Klussmann
authors.forename: Rolf-Peter
authors.initials: RP
authors.lastname: Müller
authors.forename: Simon F
authors.initials: SF
authors.lastname: Preuss
mesh_terms: D000328:Adult; D000368:Aged; D059248:Chemoradiotherapy / Q000379:methods*; D019941:Cyclin-Dependent Kinase Inhibitor p16; D066246:ErbB Receptors / Q000378:metabolism*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D051034:Inhibitor of Apoptosis Proteins / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000378:metabolism; D009959:Oropharyngeal Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000628:therapy / Q000821:virology; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000378:metabolism / Q000401:mortality* / Q000628:therapy / Q000821:virology; D016133:Polymerase Chain Reaction; D011379:Prognosis; D017422:Sequence Analysis, DNA; D015996:Survival Rate; D000077022:Survivin; D016896:Treatment Outcome
chemical_list: C107489:BIRC5 protein, human; C000614131:CDKN2A protein, human; D019941:Cyclin-Dependent Kinase Inhibitor p16; D051034:Inhibitor of Apoptosis Proteins; D009363:Neoplasm Proteins; D000077022:Survivin; D066246:ErbB Receptors