Human papillomavirus–associated oropharyngeal cancer : Not just white men anymore
Ce dossier présente une étude concernant la prévalence du papillomavirus humain (HPV) chez les patients atteints d'un carcinome épidermoïde de la tête et du cou (863 cas ; âge médian : 58 ans), une étude analysant l'association entre la réponse immunologique à ce virus et la survie des patients (1 054 cas ; âge médian : 59 ans ; 75 % d'hommes) et un essai comparant l'efficacité de deux protocoles de radiothérapie fractionnée (standard ou accélérée) en combinaison avec le cisplatine ou le panitumumab chez les patients atteints d'un carcinome épidermoïde de la tête et du cou de stade locorégionalement avancé (320 patients ; âge médian : 56 ans ; durée médiane de suivi : 46 mois)
Previous infection with human papillomavirus (HPV), in particular HPV type 16, is causally associated with oropharyngeal carcinoma (OPC). An epidemic of OPC has been noted and attributed to HPV, with the United States experiencing a significant increase in the incidence of HPV-associated OPC since the mid-1990s. As the incidence of HPV-associated OPC continues to increase, critical needs in the field include novel means to identify high-risk groups to facilitate screening and OPC diagnosis at earlier stages because more than 80% of the patients present with stage IV disease. For risk stratification, our understanding of population trends suggests that men, in particular middle-aged white men of middle to high socioeconomic status, are disproportionately affected by the rising epidemic. We also need better ways to stratify patients who already have HPV-associated OPC; current efforts include refinements to the staging system specific to HPV-associated OPC, as well as using HPV and/or p16 status and smoking status to select patients for dose de-escalation therapeutic clinical trials.
JAMA Oncology , éditorial, 2015