HPV status is associated with fatigue and inflammation in patients with squamous cell carcinoma of the Head and Neck from pre to up to 3 Months Post IMRT

Abstract

This longitudinal study examined associations among HPV, inflammation and fatigue in head and neck cancer (HNC) patients receiving intensity-modulated radiation therapy (IMRT). Consented patients were followed pre-, one-month and three-month post-IMRT. Fatigue was assessed by the Multidimensional Fatigue Inventory-20. Plasma interleukin-1receptor antagonist (IL-1ra) and soluble tumor necrosis factor receptor2 (sTNFR2) were determined using Magnetic Luminex Screening Assay; acute phase proteins (CRP) were determined using a standard turbidimetric assay. Mixed effect modeling and path analysis were used to examine the associations. Ninety-four patients with newly diagnosed, locally advanced non- metastatic HNC were enrolled from 2012 to 2015; majority received concurrent chemoradiotherapy (CRT). Fifty-three percent of them were HPV+. HPV+ patients were more likely to be male, have no history of tobacco use, have higher BMI, be diagnosed with oropharyngeal cancer, and receive CRT. HPV+ patients had significant lower fatigue, and lower inflammation as represented by CRP (p