Human Papilloma Virus is getting ready to surpass the combination of cigarette smoking and alcoholism as the leading cause of head and neck cancer. For the last ten years Oncologists have noted that patients whose cancer is related to HPV do better as a group than the others. No one knows why.
This observation has led to the idea that perhaps these patients do not require therapy as intensive as those whos cancers arise from smoking and drinking. Since the treatment of these cancers produces so many side effects, that would be a desirable result. This issue is now being studied intensively. Published in the Journal of Clinical Oncology in August 2019 is a study by a large group of investigators from many institutions led by Dr. Chera from the University of North Carolina at Chapel Hill. Clich here for a link to the abstract. Dr. Stark can send you the entire article if you wish. Just fill out the form on the right. They took a group of 114 patients with HPV-related cancers arising in the mouth and back of the throat. They comprised a diverse group in terms of the extent of disease. All were treated with radiation; the ones with more advances tumors received simultaneous chemotherapy. The investigators reduced the dose of radiation by about 15% and the dose of chemo by 25%. What they found were excellent results in all treatment groups, but side effects from the treatment were much reduced by these slight dose reductions. Importantly patients had much less burning of the mouth from the radiation and were able to eat much better.
Dr. Stark comments, The biology of HPV head and neck cancers is somehow different. These investigators have seized on this to improve therapy for this group of patients who always create management issues.