p16INK4a status and response to induction low-dose fractionated radiation in advanced head and neck cancer

Natalie L. Silver, Susanne M. Arnold, John F. Gleason, Mahesh Kudrimoti, Yolanda Brill, Emily V. Dressler, Joseph Valentino

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Objective: To evaluate the impact of p16INK4a (p16) expression on clinical efficacy of induction low-dose fractionated radiation therapy (LDFRT) with concurrent chemotherapy in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN). Study Design: Historical cohort study. Setting: Tertiary medical center. Methods: A total of 66 Patients with locally advanced SCCHN were enrolled in 2 clinical trials using paclitaxel, carboplatin, and concurrent LDFRT induction therapy. Patients were evaluated for response to induction by a multidisciplinary team and then were given definitive treatment. Adequate tissue samples from the pretreatment biopsies of 42 individuals were identified and analyzed for p16 expression. Expression was correlated with clinical outcomes. Results: Of 42 tumors, 15 (35.7%) were positive for p16. Patients with p16-positive tumors had improved response to induction, but this was not statistically significant (P = .06). Five-year overall survival was 80% in p16-positive patients and 58% in p16-negative patients (P = .025). Conclusions: p16 Expression affects treatment response in patients treated with induction LDFRT with concurrent chemotherapy. This is similar to results reported for standard induction chemotherapy.

Original languageEnglish
Pages (from-to)714-720
Number of pages7
JournalAnnals of Otology, Rhinology and Laryngology
Issue number9
StatePublished - Jan 1 2015

Bibliographical note

Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The project described was in part supported by the National Center for Advancing Translational Sciences, National Institutes of Health (NIH), through grant number UL1TR000117. Dr Dressler is supported by the National Center for Research Resources, UL1RR033173, and the National Center for Advancing Translational Sciences, UL1TR000117. The content is solely the responsibility of the authors and does not necessarily represent official views of the NIH. The initial clinical trial was supported in part by a grant from Bristol Myers Squibb.

Publisher Copyright:
© The Author(s) 2015.


  • Chemotherapy
  • Head and neck squamous cell carcinoma
  • Human papillomavirus
  • Induction
  • Low-dose
  • P16
  • Radiotherapy

ASJC Scopus subject areas

  • Otorhinolaryngology


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