Does pretreatment human papillomavirus (HPV) titers predict radiation response and survival outcomes in cancer cervix?—A pilot study

Objective.To evaluate if pretreatment HPV titers in cancer cervix could predict radiation response and survival outcomes.Methods.Twenty-one patients of cancer cervix were treated by radiotherapy (RT) alone. HPV titers were estimated using DNA Hybrid Capture II test. Loco-regional response at 1 month of RT – complete or partial response (CR and PR respectively) and survival outcomes – local disease-free (LDFS), disease-free (DFS) and overall (OS) survivals were evaluated against pre- and posttreatment HPV titers.Results.Pretreatment HPV titers ranged from 0.81 to 3966.10 RLU/cut off (mean ± SD: 1264.39 ± 1148.22, median: 1129.98). Of the demographic features evaluated, mean HPV titers were significantly different only for patients achieving CR or PR at completion of RT (mean ± SD for CR vs. PR: 1616.31 ± 1146.86 vs. 384.57 ± 538.80, P = 0.022). HPV titers at end of RT ranged from 0.12 to 487.42 RLU/cut off (mean ± SD: 37.31 ± 108.60, median: 2.33). Patients with higher pretreatment HPV titers (>1000 RLU/cutoff) had a higher CR (P = 0.022) and better survival compared to those with ≤1000 RLU/cutoff (LDFS, P = 0.004; DFS, P = 0.005; OS, P = 0.012). At completion of RT, those having ≥99.5% fall in HPV had superior survival outcomes than those with <99.5% reduction (LDFS, P = 0.002; DFS, P = 0.002; OS, P = 0.004).Conclusions.Higher pretreatment HPV titers (>1000 RLU/cutoff) could be considered as a predictor of radiotherapy response and survival in cancer cervix. A reduction in these titers to 99.5% of their baseline values at end of radiotherapy is also associated with better survival outcomes.