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Humaan Papillomavirus en hoofd/halskanker
• Hoofd/halskanker: incidentie en oorzaken
• Oropharynx carcinoom
– Incidentie
– HPV
– HPV en prognose
– Behandeling
– Preventie
Humaan Papillomavirus en hoofd/halskanker
• Hoofd/halskanker: incidentie en oorzaken
• Oropharynx carcinoom
– Incidentie
– HPV
– HPV en prognose
– Behandeling
– Preventie
Incidence Head and Neck Cancer Belgium 2011
0 100 200 300 400 500 600
Parotid gland
Salivary glands, NOS
Nasal cavity and middle ear
Accessory sinuses
Nasopharynx
Larynx
Pyriform sinus
Hypopharynx
Tonsil
Oropharynx
Lip
Base of tongue
Tongue
Gum
Floor of mouth
Palate
Mouth, NOS
Lip, oral cavity and pharynx, NOS
Males
Females
Incidence Head and Neck Cancer Belgium 2011
0 100 200 300 400 500 600
Parotid gland
Salivary glands, NOS
Nasal cavity and middle ear
Accessory sinuses
Nasopharynx
Larynx
Pyriform sinus
Hypopharynx
Tonsil
Oropharynx
Lip
Base of tongue
Tongue
Gum
Floor of mouth
Palate
Mouth, NOS
Lip, oral cavity and pharynx, NOS
Males
Females
Squamous Cell
Carcinoma (SCCHN)
Incidence Head and Neck Cancer Belgium 2011
0 100 200 300 400 500 600
Parotid gland
Salivary glands, NOS
Nasal cavity and middle ear
Accessory sinuses
Nasopharynx
Larynx
Pyriform sinus
Hypopharynx
Tonsil
Oropharynx
Lip
Base of tongue
Tongue
Gum
Floor of mouth
Palate
Mouth, NOS
Lip, oral cavity and pharynx, NOS
Males
Females
Squamous Cell
Carcinoma (SCCHN)
Involuntary Tobacco Smoking and UADT
Lee YCA et al. Cancer Epidemiol Biomarkers Prev 2009;18: 3353-3361.
Humaan Papillomavirus en hoofd/halskanker
• Hoofd/halskanker: incidentie en oorzaken
• Oropharynx carcinoom
– Incidentie
– HPV
– HPV en prognose
– Behandeling
– Preventie
Humaan Papillomavirus en hoofd/halskanker
• Hoofd/halskanker: incidentie en oorzaken
• Oropharynx carcinoom
– Incidentie
– HPV
– HPV en prognose
– Behandeling
– Preventie
Oropharyngeal cancer incidence: US
Chaturvedi AK et al. J Clin Oncol 2011; 29:4294-4301
Larynx
Oral cavity
Oropharynx
Oropharyngeal cancer incidence: Sweden
Ramqvist T, Dalianis T. Emerg Infect Dis. 2010; 16(11):1671-7
Incidence HPV+ and HPV- tonsillar SCC: Sweden
Ramqvist T, Dalianis T. Emerg Infect Dis. 2010; 16(11):1671-7
Prevalence HPV markers according to tumor site
Combes JD, Franceschi S. Oral Oncol 2013;
http://dx.doi.org/10.1016/j.oraloncology.2013.11.004
Humaan Papillomavirus en hoofd/halskanker
• Hoofd/halskanker: incidentie en oorzaken
• Oropharynx carcinoom
– Incidentie
– HPV
– HPV en prognose
– Behandeling
– Preventie
Kleine niet-omkapselde DNA
virussen, dubbelstrengig genoom dat
codeert voor
6 vroege (E1, E2, E4, E5, E6, E7)
2 late proteinen (L1, L2)
HPV
Best SR et al. Otolaryngol Clin North Am 2012; 45(4): 807–822
E6 oncoproteine leidt tot ubiquinatie
en degradatie tumor suppressor p53
deregulatie van de G1/S and
G2/M cell cycle checkpoints
HPV
Ghittoni R et al. Virus Genes 2010; 40:1–13; Narisawa-Saito M et al. Cancer Sci
2007; 98: 1505–1511; Best SR et al. Otolaryngol Clin North Am 2012;
45(4): 807–822
E7 oncoproteine: degradatie
retinoblastoma tumor suppressor
gene product (pRB)
(E5 zorgt voor upregulatie EGFR)
HPV
Ghittoni R et al. Virus Genes 2010; 40:1–13; Narisawa-Saito M et al. Cancer Sci
2007; 98: 1505–1511; Best SR et al. Otolaryngol Clin North Am 2012;
45(4): 807–822
Oral HPV infection prevalence
Chung CH et al. Oral Oncol 2013; http://dx.doi.org/10.1016/
j.oraloncology.2013.09.003
Humaan Papillomavirus en hoofd/halskanker
• Hoofd/halskanker: incidentie en oorzaken
• Oropharynx carcinoom
– Incidentie
– HPV
– HPV en prognose
– Behandeling
– Preventie
HPV and survival: RTOG 0129
HPV-16 DNA ISH HPV-16 negative 12 additional oncogenic HPV types (18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68)
p16 ICH; positive = strong and diffuse nuclear and cytoplasmic staining in 70% or more of the tumor cells
Ang KK et al. N Engl J Med 2010;363:24-35
Lassen P et al. Radiother Oncol 2013; 108: 489–494
HPV and prognosis
Posner MR et al. Ann Oncol 2011; 22: 1071–1077.
TAX 324 TROG 02.02
Rischin R et al. J Clin Oncol 2010; 28:4142-4148
HPV detectie technieken
Mirghani H et al. Oral Oncol 2014
http://dx.doi.org/10.1016/j.oraloncology.2013.10.008
Humaan Papillomavirus en hoofd/halskanker
• Hoofd/halskanker: incidentie en oorzaken
• Oropharynx carcinoom
– Incidentie
– HPV
– HPV en prognose
– Behandeling
– Preventie
Patient
Surgeon Medical
Oncologist
Dietician
Radiologist
Social worker
Psychologist
Nurse
Speech Therapist
Dentist
GP
Radio-therapist
Pathologist
Humaan Papillomavirus en hoofd/halskanker
• Hoofd/halskanker: incidentie en oorzaken
• Oropharynx carcinoom
– Incidentie
– HPV
– HPV en prognose
– Behandeling
– Preventie
Kreimer AR et al. Cancer Epidemiol Biomarkers Prev 2005;14: 467-475
HPV types in oropharyngeal cancer
Kreimer AR et al. Cancer Epidemiol Biomarkers Prev 2005;14: 467-475
Kreimer AR et al. Cancer Epidemiol Biomarkers Prev 2005;14: 467-475
Prevalence oral infections HPV16/18
Herrero Ret al. PLoS One. 2013 Jul 17;8(7):e68329. doi: 10.1371/
journal.pone.0068329
Oral infections HPV other than 16/18
Herrero Ret al. PLoS One. 2013 Jul 17;8(7):e68329. doi: 10.1371/
journal.pone.0068329
HPV status and EGFR expression
Mirghani H et al. Eur J Cancer 2014; http://dx.doi.org/10.1016/j.ejca.2013.12.018
Alcoholic Beverage and Head and Neck Cancer: INHANCE
Purdue MP et al. Am J Epidemiol 2009; 169(2):132-42
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