title: p16INK4a Status and Response to Induction Low-Dose Fractionated Radiation in Advanced Head and Neck Cancer.
abstract: OBJECTIVE
  To evaluate the impact of p16INK4a (p16) expression on clinical efficacy of induction low-dose fractionated radiation therapy (LDFRT) with concurrent chemotherapy in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN).
  
  
  METHODS
  Historical cohort study.
  
  
  METHODS
  Tertiary medical center.
  
  
  METHODS
  A total of 66 Patients with locally advanced SCCHN were enrolled in 2 clinical trials using paclitaxel, carboplatin, and concurrent LDFRT induction therapy. Patients were evaluated for response to induction by a multidisciplinary team and then were given definitive treatment. Adequate tissue samples from the pretreatment biopsies of 42 individuals were identified and analyzed for p16 expression. Expression was correlated with clinical outcomes.
  
  
  RESULTS
  Of 42 tumors, 15 (35.7%) were positive for p16. Patients with p16-positive tumors had improved response to induction, but this was not statistically significant (P = .06). Five-year overall survival was 80% in p16-positive patients and 58% in p16-negative patients (P = .025).
  
  
  CONCLUSIONS
  p16 Expression affects treatment response in patients treated with induction LDFRT with concurrent chemotherapy. This is similar to results reported for standard induction chemotherapy.
authors: Department of Otolaryngology HNS, University of Kentucky College of Medicine, Lexington, Kentucky, USA nataliesilvermd@gmail.com.
authors: Natalie L
authors: NL
authors: Silver
authors: Division of Medical Oncology, University of Kentucky College of Medicine, Lexington, Kentucky, USA.
authors: Susanne M
authors: SM
authors: Arnold
authors: Department of Radiation, University of Kentucky College of Medicine, Lexington, Kentucky, USA.
authors: John F
authors: JF
authors: Gleason
authors: Department of Radiation, University of Kentucky College of Medicine, Lexington, Kentucky, USA.
authors: Mahesh
authors: M
authors: Kudrimoti
authors: Department of Pathology, University of Kentucky College of Medicine, Lexington, Kentucky, USA.
authors: Yolanda
authors: Y
authors: Brill
authors: Division of Cancer Biostatistics, University of Kentucky College of Public Health, Lexington, Kentucky, USA.
authors: Emily V
authors: EV
authors: Dressler
authors: Department of Otolaryngology HNS, University of Kentucky College of Medicine, Lexington, Kentucky, USA.
authors: Joseph
authors: J
authors: Valentino
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage; D001706:Biopsy; D016190:Carboplatin / Q000008:administration & dosage*; D002294:Carcinoma, Squamous Cell / Q000235:genetics / Q000473:pathology / Q000628:therapy; D059248:Chemoradiotherapy / Q000379:methods*; D015331:Cohort Studies; D019583:Dose Fractionation, Radiation; D004307:Dose-Response Relationship, Radiation; D005260:Female; D020869:Gene Expression Profiling; D019942:Genes, p16 / Q000502:physiology*; D006258:Head and Neck Neoplasms / Q000235:genetics / Q000473:pathology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000628:therapy; D017239:Paclitaxel / Q000008:administration & dosage*; D030361:Papillomavirus Infections / Q000235:genetics / Q000473:pathology / Q000628:therapy; D012074:Remission Induction / Q000379:methods; D000077195:Squamous Cell Carcinoma of Head and Neck; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D016190:Carboplatin; D017239:Paclitaxel
keywords: chemotherapy; head and neck squamous cell carcinoma; human papillomavirus; induction; low-dose; p16; radiotherapy