Title:Impact of Human Papillomavirus (HPV) Infection on the Treatment Outcome
of Concomitant Chemoradiotherapy (CRT) in Cervical Cancer
Volume: 20
Issue: 3
Author(s): Atar Singh Kushwah, Kirti Srivastava, Rajnikant Mishra and Monisha Banerjee*
Affiliation:
- Molecular and Human Genetics Laboratory, Department of Zoology, University of Lucknow, Lucknow -226007, Uttar
Pradesh, India
Keywords:
Cervical cancer, chemoradiotherapy (CRT), CaCx Patients, human papillomavirus (HPV) infection, treatment outcome, overall survival.
Abstract:
Background: Human Papilloma Virus (HPV) infection and its persistence are responsible
for the development of cervical cancer (CaCx). Chemoradiotherapy (CRT) is the only treatment option,
especially in advanced stages. However, it is not influenced by the status of HPV infection. CRT
controls cancer growth along with mild to severe adverse effects.
Objective: The aim of this study was to assess the HPV-associated risk factors and correlate them
with chemoradiation therapy (CRT) response in cervical cancer.
Methods: The study was undertaken in 103 histologically positive CaCx patients. Anthrodemographic
and obstetric characterizations were conducted by face-to-face interviews, and HPV
testing was done by conventional PCR. All the patients received a 40-50Gy total effective dose using
tele- and brachytherapy. The treatment response, survivorship and statistical analysis were made using
GraphPad Prism 9 and SPSS (ver.25.0).
Results: Out of 103 patients, 84% were HPV infected, and 16% CaCx were HPV-negative. Advanced
age, lower-middle socioeconomic status (SES), illiteracy, and patients from rural backgrounds were
significantly higher in CaCx patients with HPV infection. Multiparity, irregular menstrual cycle, poor
menstrual hygiene, and use of contraception were significantly associated with HPV positivity. Patients
with HPV infection showed a better clinical response (P =0.031), alive vital status (P =0.007),
and 59 months of median survival (P <0.001) with a poor hazard ratio (HR 0.29 at 95% CI).
Conclusion: HPV-infected CaCx patients showed better response to definitive chemoradiation therapy
compared to HPV-negative with a poor hazard ratio. Therefore, HPV testing can potentially stratify
CaCx patients for more effective therapeutic regimens, treatment assessments and follow-ups.
