Radiation Dose Reduction may Help Treat HPV-Positive Oropharynx Cancer

Highlights

• Human Papillomavirus infections can cause cancer behind the throat or at the base of the tongue and tonsils.
• Reducing the radiation may help to minimize side effects and improve treatment options for HPV-positive oropharyngeal cancer, finds a study from Yale Cancer Center.
• Radiation dose reduction was found to improve swallowing and impaired nutrition in cancer patients.

Reducing the radiation for some patients with Human papillomavirus - associated oropharyngeal squamous cell carcinoma may help to minimize the side effects and maintain successful cure rate for the disease, finds a recent clinical trial study from the Yale Cancer Center. The research study was published in the Journal of Clinical Oncology.

Human Papillomavirus (HPV) is a sexually transmitted virus that infects the oropharynx, anus and genitals. HPV may also cause cancer or warts.

In the United States, around 20 million people suffer from some type of HPV infection. Human Papillomavirus causes cancer behind the throat or at the base of the tongue and the tonsils. These cancers are referred to as Oropharyngeal cancers. Oral HPV infection may lead to HPV-positive oropharyngeal squamous cell cancer.

Barbara Burtness, MD, Professor of Medicine, Yale Cancer Center, Research Leader for Head and Neck Cancers Program at Smilow Cancer Hospital, chair of ECOG-ACRIN head and neck committee, said, “We found there are some patients have very high cure rates with reduced doses of radiation.”

“Radiation dose reduction resulted in significantly improved swallowing and nutritional status.”

Research Study on HPV Oropharyngeal Cancer Patients

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The research study was conducted on 80 patients from 16 ECOG-ACRIN Research group (Eastern Cooperative Oncology Group (ECOG) and the American College of Radiology Imaging Network (ACRIN) who are in stage 3 or 4 HPV - positive oropharynx cancer and were candidates for surgery.

Three courses of induction chemotherapy which included drugs like cisplatin, paclitaxel, cetuximab were received by patients.

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Patients who responded well to the drugs were given a reduced dose of radiation.

Findings of the Study

• 40% of the patients treated with reduced dose of radiation had less difficulty in swallowing solids when compared to 89% of patients treated with a standard dose of radiation.
• 10% of the patients who received reduced dose of radiation faced impaired nutrition when compared to 44% of the patients with standard dose.
• Patients who smoke less than 10 packs of cigarettes a year had a very high effective control of the disease when compared to heavy smokers.

Dr. Burtness, said, “Today, many younger patients are presenting with HPV-associated squamous cell carcinoma of the oropharynx.”

“And while traditional chemo-radiation has demonstrated good tumor control and survival rates for patients, too often they encounter unpleasant outcomes that can include difficulty swallowing solid foods, impaired nutrition, aspiration and feeding tube dependence.”

“Younger patients may have to deal with these side effects for decades after cancer treatment. We want to help improve our patients’ quality of life,” she said.

Interesting Facts on HPV

• It is one of the most common sexually transmitted infection in the United States.
• HPV is a leading cause of oropharyngeal cancers.
• Around 10% of men and 3.6% of women are infected with oral HPV in the United States. Men are four times more prone to oropharyngeal cancer when compared to women.
• There are about 200 different strains of HPV virus which are harmless and does not cause cancer.
• People who have a weak immune system are at a greater risk for HPV infections.
• Smoking and alcohol consumption are strong risk factors for oropharyngeal cancers.

Symptoms of Oropharyngeal Cancer

• Sore throat
• Earache
• Enlarged lymph nodes
• Pain during swallowing
• Weight loss

References

1. HPV / Oral Cancer Facts - (http://oralcancerfoundation.org/understanding/hpv/hpv-oral-cancer-facts/)
2. HPV and Head & Neck Cancer - (http://www.hopkinsmedicine.org/kimmel_cancer_center/centers/head_neck/HPV/)
3. HPV and Oropharyngeal Cancer - Fact Sheet - (https://www.cdc.gov/std/hpv/stdfact-hpvandoropharyngealcancer.htm)
4. Reducing Radiation Successfully Treats HPV-Positive Oropharynx Cancers and Minimizes Side Effects - (http://yalecancercenter.org/news/article.aspx?id=14151)

Source-Medindia