title: Adverse effect of smoking on prognosis in human papillomavirus-associated oropharyngeal carcinoma.
abstract: The purpose of this retrospective study was to identify prognostic factors in a cohort of patients with oropharyngeal carcinoma treated with intensity-modulated radiotherapy (IMRT).
  
  
  
  Medical records of 142 patients treated with (chemo)radiotherapy between September 2005 and September 2011 were reviewed and the human papillomavirus (HPV) status was determined by polymerase chain reaction (PCR) analysis. Potential prognostic factors for 3-year locoregional control and overall survival (OS) were evaluated.
  
  
  
  HPV-positive patients (n = 82) had locoregional control and OS of 78% and 79%, respectively. Significant prognostic factors on multivariate analysis were smoking (p = .03) for locoregional control and OS, and comorbidity (p = .04) for OS. Further stratification was done according to smoking behavior in HPV-positive patients. Locoregional control in current smokers was 67% compared to 86% in never smokers and former smokers, respectively (p = .02).
  
  
  
  Smoking was the only modifiable prognostic factor in HPV-positive patients. Therefore, active stop-smoking programs must be integrated in the routine management of patients to maximize treatment results. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1780-1787, 2016.
authors.affiliation: Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Carmen P
authors.initials: CP
authors.lastname: Liskamp
authors.affiliation: Department of Radiation Oncology, Utrecht University Medical Center, Utrecht, The Netherlands.
authors.forename: Geert O
authors.initials: GO
authors.lastname: Janssens
authors.affiliation: Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Johan
authors.initials: J
authors.lastname: Bussink
authors.affiliation: Department of Medical Microbiology, Radboud University Medical Center Nijmegen, The Netherlands.
authors.forename: Willem J
authors.initials: WJ
authors.lastname: Melchers
authors.affiliation: Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Johannes H
authors.initials: JH
authors.lastname: Kaanders
authors.affiliation: Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Cornelia G
authors.initials: CG
authors.lastname: Verhoef
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology* / Q000628:therapy; D015331:Cohort Studies; D003131:Combined Modality Therapy; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009959:Oropharyngeal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy / Q000821:virology*; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D016019:Survival Analysis
keywords: human papillomavirus (HPV); intensity-modulated radiotherapy (IMRT); oropharyngeal carcinoma; radiotherapy; smoking