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Published on: June 14, 2019
Is there any correlation between HPV and early radioresponse before brachytherapy in cervix uteri carcinoma?
Binnur Dönmez Yılmaz1, Emre Uysal2, Necla Gurdal2
1Department of Radiation Oncology, Okmeydani Training and Research Hospital, İstanbul, Turkey. binnurdy@yahoo.com.
Objective:
The prognostic effect of human papilloma virus (HPV) on early radioresponse before brachytherapy was evaluated in locally advanced cervix uteri carcinoma patients.
Methods:
Between 2015 and 2018, 150 patients with locally advanced carcinoma of the cervix uteri from University of Health Sciences Okmeydani Training and Research Hospital and Istanbul Oncology Hospital underwent chemotherapy concomitant with external radiotherapy and brachytherapy after performing fluorodeoxyglucose positron emission tomography (FDG PET) and magnetic resonance imaging (MRI) for purposes of staging and treatment planning. The treatment results of patients analyzed retrospectively.
Results:
The median age of 57 patients was 53 years, and the initial tumor volume was 27 cm3. The median follow-up period was 22 months. The median tumor volume after external radiotherapy was significantly higher in patients without local control than those who responded to external radiotherapy (p = 0.031). The mean tumor diameter and volume in all HPV-negative patients after external radiotherapy were significantly higher than those of HPV-positive patients (p = 0.011 and p = 0.046, respectively). In a group of patients with poor early responses, local disease control could not be achieved despite the use of recommended higher doses of brachytherapy.
Conclusion:
We could not determine the correlation between HPV contamination and patients who had early response intervention. But residual tumor of more than 2 cm in diameter after external radiotherapy may be a predictor of failed local control and development of metastasis within a short time.
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