Impact of the presence of hpv dna in cervical cancer on treatment response in patients receiving radical radiotherapy – a regional cancer centre study

Background: While HPV has evolved as a significant prognosticator in Carcinoma oropharynx it fails to be so in case of Ca Cervix. The existing literature is divided in this topic mainyowing todemograhic-trends, techniques and HPV subtype-specific epidemiology. So considering the load and mortalitiy associated with the disease in our country a study on the local population to assess for role of HPV status in treatment response and toxicity profile was endeavoured Method: A prospective study was performed on 120 cervical cancer patients meeting inclusion criterion their HPV status was assessed via PCR. Patients were treated with concurrent CTRT in the form of EBRT 50Gy / 2Gy/# / 5 days a week with concurrentweeklyCisplatin 40 mg/m2, followed by brachytherapy.The patients were followed upon regular basis to assess their acute toxicity profile and treatment response Results: The primary endpoint of DFS at 2 year was analysed. There were 21 recurrences in the HPV Positive arm compared to 3 in the HPV negative arm. (P=0.0122). The treatment response at one month after treatment (RECIST Criterion) was analysed there was residual disease in only 2 of the HPV negative cases(10%) compared to 18 in HPV Positive arm(22.5%) (P<0.05). Toxicity profile in terms of both acute and late had no statistical difference among the groups Discussion: The study adds evidence to support the fact that HPV has a definite role as a biomarker in the prognostication and treatment outcome of cervical cancer. But the authors equally respect the outcomes which contradicts this study. As our country is perhaps the capital of cervical cancer, more studies on local population is the need of the hour to throw more light into this dilemma