Multicentre study of inoperable HPV-negative head and neck cancer: a persistent real-world challenge.

IF 1.7 Q4 ONCOLOGY

Reports of Practical Oncology and Radiotherapy Pub Date : 2026-08-01 eCollection Date: 2026-01-01 DOI:10.5603/rpor.112755

Marek Slavik, Iveta Selingerova, Jakub Cvek, Dukagjin M Blakaj, Tomas Blazek, Lukáš Knybel, Zuzana Zdeblova Cermakova, Jan Cincibuch, Tomas Novotny, Petr Burkon, Pavel Slampa, Tomas Kazda, Martin Dolezel

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引用次数: 0

Abstract

Background: HPV-negative head and neck squamous cell carcinoma (HNSCC) has a poorer prognosis than HPV-positive tumours, yet real-world outcomes remain understudied. This study analyses a multicentre cohort of HPV-negative HNSCC patients, including those over 65 years of age.

Materials and methods: This retrospective study included HPV-negative HNSCC patients treated with definitive radiotherapy (RT) or chemoradiotherapy (CRT) between 2015 and 2020. RT protocols included standard fractionation (70 Gy, 35 fractions), simultaneous integrated boost (69.96 Gy, 33 fractions), or concomitant boost (72.5 Gy, 50 fractions).

Results: Among 225 patients (62 over 65 years), 138 (61%) received CRT. Local progression occurred in 83 (37%), and 177 (79%) died. Median overall survival (OS) was 23.1 months, with 3-year OS and local control (LC) rates of 37% and 35%, respectively. ECOG predicted outcomes (p < 0.001 for OS, p = 0.040 for LC), while comorbidity burden and disease stage were significant only for OS (p < 0.001 and p = 0.006). CRT improved OS over RT alone (p = 0.059). Older patients more often had hypopharyngeal/laryngeal tumours (p = 0.033), received CRT less frequently (29% vs. 74%, p < 0.001), and chemotherapy did not affect outcomes.

Conclusions: Real-world outcomes for inoperable HPV-negative HNSCC remain poor. Personalized approaches are needed to improve care for this challenging population.

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不可手术的hpv阴性头颈癌的多中心研究：一个持续的现实世界的挑战。

背景：hpv阴性头颈部鳞状细胞癌（HNSCC）的预后比hpv阳性肿瘤差，但现实世界的结果仍未得到充分研究。本研究分析了hpv阴性HNSCC患者的多中心队列，包括65岁以上的患者。材料和方法：本回顾性研究包括2015年至2020年间接受最终放疗（RT）或放化疗（CRT）治疗的hpv阴性HNSCC患者。RT方案包括标准分馏（70 Gy， 35个分数），同时集成增压（69.96 Gy， 33个分数）或伴随增压（72.5 Gy， 50个分数）。结果：225例患者（65岁以上62例）中，138例（61%）接受了CRT治疗。83例（37%）发生局部进展，177例（79%）死亡。中位总生存期（OS）为23.1个月，3年OS和局部控制率（LC）分别为37%和35%。ECOG预测预后（OS的p < 0.001， LC的p = 0.040），而合并症负担和疾病分期仅对OS有统计学意义（p < 0.001和p = 0.006）。CRT较单纯RT改善OS （p = 0.059）。老年患者更常患有下咽/喉部肿瘤（p = 0.033），接受CRT的频率更低（29%对74%，p < 0.001），化疗对预后没有影响。结论：无法手术的hpv阴性HNSCC的现实预后仍然很差。需要个性化的方法来改善对这一具有挑战性的人群的护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Reports of Practical Oncology and Radiotherapy Multiple-

CiteScore

2.80

自引率

8.30%

发文量

115

审稿时长

16 weeks

期刊介绍： Reports of Practical Oncology and Radiotherapy is an interdisciplinary bimonthly journal, publishing original contributions in clinical oncology and radiotherapy, as well as in radiotherapy physics, techniques and radiotherapy equipment. Reports of Practical Oncology and Radiotherapy is a journal of the Polish Society of Radiation Oncology, the Czech Society of Radiation Oncology, the Hungarian Society for Radiation Oncology, the Slovenian Society for Radiotherapy and Oncology, the Polish Study Group of Head and Neck Cancer, the Guild of Bulgarian Radiotherapists and the Greater Poland Cancer Centre, affiliated with the Spanish Society of Radiotherapy and Oncology, the Italian Association of Radiotherapy and the Portuguese Society of Radiotherapy - Oncology.