Outcome after different treatments for patients with HPV+ tonsillar cancer.

Abstract

e16048 Background: In the last few years, oncological treatment for tonsillar cancer has intensified with accelerated radiotherapy and chemotherapy, which has resulted in more side effects. Patients with HPV-positive tonsillar cancer have better prognosis than those with HPV-negative tumors, and it is possible that patients with HPV-positive tonsillar cancer may benefit from a reduced, less-toxic treatment without compromising survival. Methods: To evaluate the possible difference in survival after different oncological treatments of patients with HPV-positive tonsillar cancer, we evaluated all 211 patients diagnosed with tonsillar cancer between 2000-2007, in Stockholm, Sweden. Included patients were those with available pretreatment biopsies, and treated with intent to cure. A total of 172 patients had HPV-positive tumors and of those, 98 were treated with conventional radiotherapy, 44 were treated with accelerated radiotherapy and 30 were treated with chemoradiotherapy. Results: No significant differences in overall and disease-free survival were seen between the three treatment groups, but there was a trend, where chemoradiotherapy was better than radiotherapy; and accelerated radiotherapy was better than conventional radiotherapy. This trend needs to be followed further. Conclusions: In this study, patients with HPV-positive tonsillar cancer treated with conventional radiotherapy, accelerated radiotherapy or chemoradiotherapy had similar survival rates. However, there is a trend for better survival and less metastasis after intensified treatment underlining the need for prospective studies, where less intense treatment is compared to more intense treatment.