The influence of HPV-associated XXXX -expression on accelerated fractionated radiotherapy in head and neck cancer: evaluation of the randomised DAHANCA 6_7 trial.

@entity5 @entity1 @entity213 @entity986
BACKGROUND AND PURPOSE: @entity5 is a favourable prognostic factor in the radiotherapy of @entity213 , but the optimal radiotherapy regimen for HPV-positive @entity213 is not yet defined. Reducing overall treatment time is known to improve outcome in the radiotherapy of @entity213 as was also demonstrated in the randomised DAHANCA 6_7 trial. We aimed to assess the influence of @entity5 HPV-status, expressed by @entity986 , on the response to accelerated fractionated radiotherapy in @entity213 through evaluation of the DAHANCA 6_7 trial. MATERIALS AND METHODS: Immunohistochemical detection of HPV-associated @entity986 -expression was performed on FFPE-pre-treatment @entity5 -tissues from 794 @entity1 enrolled in the DAHANCA 6_7 trial. The influence of @entity5 @entity986 -status on loco-regional @entity5 control and survival as a function of fractionation schedule (5Fx/week vs 6Fx/week) was evaluated 5years after the completion of radiotherapy. RESULTS: The significant and independent prognostic value of @entity5 @entity986 -positivity in @entity213 radiotherapy was confirmed, with adjusted hazard ratios (HR) of 0.58 [0.43-0.78], 0.47 [0.33-0.67] and 0.54 [0.42-0.68] for loco-regional control, disease-specific and overall survival, respectively. Accelerated radiotherapy significantly improved loco-regional @entity5 control compared to conventional radiotherapy, adjusted HR: 0.73 [0.59-0.92] and the benefit of the 6Fx/week regimen was observed both in @entity986 -positive (HR: 0.56 [0.33-0.96]) as well as in @entity986 -negative @entity5 (HR: 0.77 [0.60-0.99]). Disease-specific survival was also significantly improved with accelerated radiotherapy in the group of @entity986 -positive @entity5 (adjusted HR: 0.43 [0.22-0.82]). CONCLUSION: Accelerated radiotherapy significantly improves outcome in @entity213 compared to conventional fractionation. The observed benefit is independent of @entity5 @entity986 -status and the use of a moderately accelerated radiotherapy regimen seems advantageous also for HPV/ @entity986 -positive @entity213 .
