title: Concurrent chemoradiotherapy with cisplatin or cetuximab for locally advanced head and neck squamous cell carcinomas: Does human papilloma virus play a role?
abstract: The optimal concurrent regimen, chemoradiotherapy (CRT) or bioradiotherapy (BRT), in locally advanced head and neck squamous cell carcinoma (LAHNSCC) remains controversial, especially in human papilloma virus-associated patients.
  
  
  
  Data of 265 patients with LAHNSCC treated with CRT (cisplatin, 100mg/m(2) every 3weeks, n=194) or BRT (weekly cetuximab, n=71), including 119 patients with known HPV/p16 status were analyzed.
  
  
  
  Median follow-up was 54.5months. The 5-year progression-free survival (PFS) and locoregional control (LRC) were 51.7% vs. 36.9% (p=0.01) and 74.2% vs. 51.2% (p=0.002), both in favor of CRT. Multivariate analysis adjusted for p16 status continued to show improved outcomes (PFS and LRC) for CRT. The 5-year LRC was significantly better with CRT vs. BRT both in the p16+ subgroup (p=0.01) and in p16- or unknown subgroup (p=0.02), and 5-year PFS was of non-significant trend of improvement with CRT vs. BRT in both subgroups (p=0.07 in p16+ and p=0.09 in p16- or unknown, respectively). In the subset of oropharyngeal cancer patients with HPV/p16 status available (n=88), MVA after adjusted for other clinical co-variates showed a non-significant trend of improvement of LRC with CRT compared with BRT (HR=0.4, 95%CI, 0.1-1.0; p=0.06).
  
  
  
  Our long-term results suggested better outcomes in LAHNSCC patients receiving concurrent cisplatin over cetuximab regardless of HPV/p16 status.
authors.affiliation: Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France; Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Ou
authors.affiliation: Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France.
authors.forename: Antonin
authors.initials: A
authors.lastname: Levy
authors.affiliation: Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Blanchard
authors.affiliation: Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France.
authors.forename: France
authors.initials: F
authors.lastname: Nguyen
authors.affiliation: Department of Pathology, Institut Gustave Roussy, Villejuif, France.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Garberis
authors.affiliation: Department of Pathology, Institut Gustave Roussy, Villejuif, France.
authors.forename: Odile
authors.initials: O
authors.lastname: Casiraghi
authors.affiliation: Department of Pathology, Institut Gustave Roussy, Villejuif, France.
authors.forename: Jean-Yves
authors.initials: JY
authors.lastname: Scoazec
authors.affiliation: Department of Head and Neck Oncology, Institut Gustave Roussy, Villejuif, France.
authors.forename: François
authors.initials: F
authors.lastname: Janot
authors.affiliation: Department of Head and Neck Oncology, Institut Gustave Roussy, Villejuif, France.
authors.forename: Stephane
authors.initials: S
authors.lastname: Temam
authors.affiliation: Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Deutsch
authors.affiliation: Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France. Electronic address: yungan.tao@gustaveroussy.fr.
authors.forename: Yungan
authors.initials: Y
authors.lastname: Tao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000628:therapy* / Q000821:virology; D000068818:Cetuximab / Q000008:administration & dosage*; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage*; D005260:Female; D006258:Head and Neck Neoplasms / Q000628:therapy* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae; D015996:Survival Rate
chemical_list: D000068818:Cetuximab; D002945:Cisplatin
keywords: Cetuximab; Chemoradiotherapy; Cisplatin; HPV; Head and neck cancer; Oropharyngeal cancer; p16