title: Stereotactic body radiotherapy for recurrent oropharyngeal cancer - influence of HPV status and smoking history.
abstract: OBJECTIVE
  HPV status and smoking history stratifies patients into 3 distinct risk groups for survival following definitive chemoradiotherapy. Local-regional recurrences are common patterns of failure across all 3 risk-groups. SBRT±cetuximab has emerged as a promising salvage strategy for unresectable locally-recurrent, previously-irradiated head-and-neck cancer (rHNC) relative to conventional re-irradiation±chemotherapy. However the influence of HPV and smoking remains unknown in the setting of re-irradiation.
  
  
  METHODS
  Patients (n=30) with rHNC of the oropharynx salvaged with SBRT±cetuximab from August 2002 through August 2013 were retrospectively reviewed; HPV status was determined based on p16 staining of primary pathology.
  
  
  RESULTS
  At a median follow-up of 10months for surviving patients, the mean overall survival for all patients was 12.6 months. HPV positivity was a significant predictor of overall survival (13.6 vs. 6.88 months, p=0.024), while smoking status did not significantly impact overall survival (p=0.707).
  
  
  CONCLUSIONS
  HPV status remains a significant predictor of overall survival in the re-irradiation setting with HPV positive rHNC demonstrating superior overall survival following salvage SBRT±cetuximab.
authors.affiliation: University of Pittsburgh Medical Center, Department of Otolaryngology - Head and Neck Surgery, Pittsburgh, PA, USA. Electronic address: davisks@upmc.edu.
authors.forename: Kara S
authors.initials: KS
authors.lastname: Davis
authors.affiliation: University of Pittsburgh Medical Center, Department of Radiation Oncology, Pittsburgh, PA, USA.
authors.forename: John A
authors.initials: JA
authors.lastname: Vargo
authors.affiliation: University of Pittsburgh Medical Center, Department of Otolaryngology - Head and Neck Surgery, Pittsburgh, PA, USA.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Ferris
authors.affiliation: University of Pittsburgh Medical Center, Department of Radiation Oncology, Pittsburgh, PA, USA.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Burton
authors.affiliation: UPMC Cancer Center, Medical Oncology, Pittsburgh, PA, USA.
authors.forename: James P
authors.initials: JP
authors.lastname: Ohr
authors.affiliation: University of Pittsburgh Medical Center, Department of Radiation Oncology, Pittsburgh, PA, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Clump
authors.affiliation: University of Pittsburgh Medical Center, Department of Radiation Oncology, Pittsburgh, PA, USA.
authors.forename: Dwight E
authors.initials: DE
authors.lastname: Heron
mesh_terms: D000368:Aged; D052685:Alphapapillomavirus / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009959:Oropharyngeal Neoplasms / Q000503:physiopathology / Q000532:radiotherapy* / Q000821:virology; D016634:Radiosurgery; D012907:Smoking
keywords: Human papilloma virus; Oropharyngeal; Radiosurgery; Recurrence; Stereotactic body radiotherapy