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Human papillomavirus status in advanced cervical cancer: predictive and prognostic significance for curative radiation treatment
  1. K. Lindel*,
  2. P. Burri*,
  3. H. U. Studer*,
  4. H. J. Altermatt,
  5. R. H. Greiner* and
  6. G. Gruber*
  1. * Department of Radiation Oncology, Inselspital, University of Berne, Bern, Switzerland
  2. Institute of Pathology Laenggasse, Bern, Switzerland
  1. Address correspondence and reprint requests to: Katja Lindel, MD, Universitätsklinikum Radiologische Klinik, Abt. Klinische Radiologie, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany. Email: katja_lindel{at}med.uni-heidelberg.de
  1. Presented at the following scientific meetings: 7th Annual Meeting of the German Society for Radiation Oncology, September 8–11, 2001, and 43rd Annual Meeting of the American Society for Therapeutic Radiology and Oncology, November 4–8, 2001.

Abstract

Human papillomavirus (HPV) infection plays a major role in oncogenesis of squamous cell carcinoma of the cervix. This study was performed to investigate if HPV status and E2 gene integrity are prognostic parameters for clinical outcome and predictive for radiation response. Forty women with locally advanced cervical cancer treated with curative radiotherapy were analyzed for HPV infection and E2 gene integrity by multiplex polymerase chain reaction. Statistical analyses were performed for overall survival, disease-free survival (DFS), local progression-free survival, and treatment response (clinical complete remission). Twenty-eight (70%) of 40 carcinomas were HPV positive. The only significant factor for a better overall survival, DFS, and local progression-free survival was HPV positivity (P < 0.02, P = 0.02, and P < 0.05, log-rank, respectively). HPV-positive tumors had a significantly better clinical complete remission (67% vs 33%, P = 0.04, Fisher's exact test). An intact E2 gene region showed a trend for a better DFS (P = 0.1, log-rank). This study reveals HPV as an independent prognostic parameter for outcome and radiation response. Integration of the virus genome into host cell DNA might be a molecular target to determine the treatment response of HPV-positive cancers.

  • cervical cancer
  • human papillomavirus
  • radiation

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