Review
HPV & head and neck cancer: a descriptive update
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* Corresponding author: Holger H Sudhoff holger.sudhoff@rub.de
1 Department of Pathology, University of Cambridge, Cambridge, UK
2 Department of Otolaryngology, Head and Neck Surgery, Bielefeld Academic Teaching Hospital, Bielefeld, Germany
3 Department of Plastic Surgery and Burn Centre, BG University Hospital Bergmannsheil, Ruhr University Bochum, Germany
4 The University College London, Ear Institute, Gray's Inn Road, London, UK
5 Department of Otolaryngology, Head and Neck Surgery, Hospital Clinic of Barcelona, University of Barcelona, Spain
6 Department of Hematology and Oncology, Bielefeld Academic Teaching Hospital, Bielefeld, Germany
Head & Neck Oncology 2009, 1:36 doi:10.1186/1758-3284-1-36
Published: 14 October 2009Abstract
The incidence of head and neck squamous cell carcinoma (HNSCC) has been gradually increasing over the last three decades. Recent data have now attributed a viral aetiology to a subset of head and neck cancers. Several studies indicate that oral human papillomavirus (HPV) infection is likely to be sexually acquired. The dominance of HPV 16 in HPV+ HNSCC is even greater than that seen in cervical carcinoma of total worldwide cases. Strong evidence suggests that HPV+ status is an important prognostic factor associated with a favourable outcome in head and neck cancers.
Approximately 30 to 40% of HNSCC patients with present with early stage I/II disease. These patients are treated with curative intent using single modality treatments either radiation or surgery alone. A non-operative approach is favored for patients in which surgery followed by either radiation alone or radiochemotherapy may lead to severe functional impairment. Cetuximab, a humanized mouse anti-EGFR IgG1 monoclonal antibody, improved locoregional control and overall survival in combination with radiotherapy in locally advanced tumours but at the cost of some increased cardiac morbidity and mortality.
Finally, the improved prognosis and treatment responses to chemotherapy and radiotherapy by HPV+ tumours may suggest that HPV status detection is required to better plan and individualize patient treatment regimes.