A comparison of loco-regional relapse pattern in HPV positive vs negative oropharyngeal cancers following radiotherapy; relation to pretreatment FDG-PET and radiotherapy target volumes

Abstract

BACKGROUND: Previous studies have shown that a large proportion of relapses in head-and neck squamous cell carcinoma (HNSCC) following radiotherapy (RT) occur in the pretreatment FDG-PET avid volume (GTV-PET). The aim of the current work was to see if this was valid also in an oropharynx squamous cell carcinoma (OPSCC) only population, and to compare the loco-regional relapse pattern between HPV positive and HPV negative patients.

MATERIAL AND METHODS: Among 633 OPSCC patients treated between 2009 and 2017, 46 patients with known HPV (p16) status and isolated loco-regional relapse were included. Oncologists contoured relapse volumes (RV) on relapse scans (PET/CT, CT or MR), which were thereafter deformed to match the anatomy of the planning CTs. The point of origin (center of volume) of the deformed RVs were determined and analyzed in relation to the RT target volumes (GTV-PET, GTV and CTVs). The relapse pattern was compared between HPV positive and HPV negative patients using Fischer's exact test.

RESULTS: Sixty RVs were contoured in the 46 patients. 55% (95% CI 44-67%) of relapses originated in GTV-PET, while the other RT volumes harbored 12% (5-20%) (GTV), 18% (9-28%) (high risk CTV) and 5% (0-11%) (low risk CTV) of relapses. Six relapses were found outside the RT target volumes. No significant difference in relapse pattern between HPV positive and HPV negative patients was found (p = .95).

CONCLUSION: There were no signs of difference in loco-regional relapse pattern between HPV positive and HPV negative patients. In agreement with previous findings, GTV-PET was the most frequent RT target volume of relapse.

Original languageEnglish
JournalActa Oncologica
Volume62
Issue number9
Pages (from-to)1028-1035
Number of pages8
ISSN0284-186X
DOIs
Publication statusPublished - Sept 2023

Keywords

  • Chronic Disease
  • Fluorodeoxyglucose F18
  • Head and Neck Neoplasms
  • Humans
  • Oropharyngeal Neoplasms/diagnostic imaging
  • Papillomavirus Infections/diagnostic imaging
  • Positron Emission Tomography Computed Tomography
  • Positron-Emission Tomography
  • Radiopharmaceuticals
  • Recurrence
  • Squamous Cell Carcinoma of Head and Neck/diagnostic imaging
  • pretreatment FDG-PET
  • pattern of failure
  • HPV
  • Head-and-neck cancer

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