Controversies in Treatment Deintensification of Human Papillomavirus–Associated Oropharyngeal Carcinomas: Should We, How Should We, and for Whom?
Menée sur 505 patients atteints d'un cancer oropharyngé associé ou non au papillomavirus humain (HPV) et traités par radiothérapie ou chimioradiothérapie entre 2001 et 2009 (durée médiane de suivi : 3,9 ans), cette étude identifie les patients HPV+ pouvant bénéficier d'un traitement moins intense en conservant un risque minimal de métastases distantes
It has been little more than a decade since the recognition of the epidemiology, distinct molecular biology, and profile of risk factors, patient demographics, and tumor characteristics of human papillomavirus (HPV) –associated oropharyngeal squamous cell carcinoma (OPSCC). From prospective and retrospective studies, we know that patients with locally advanced, stage III/IV, HPV-associated OPSCC who are treated with standard cisplatin-based concurrent chemoradiotherapy have significantly better overall survival and reduced risk of recurrence compared with patients with HPV-negative OPSCC. More than 80% will likely be cured of their cancer. That said, it is also evident that a subset of patients demonstrate an aggressive phenotype with the development of distant spread and death as a result of their cancer...
Journal of Clinical Oncology , éditorial en libre accès, 2013