USE OF BIOLOGICAL PARAMETERS TO DE-ESCALATE CHEMORADIATION IN HPV ASSOCIATED SQUAMOUS CELL CARCINOMA OF DIFFERENT SUBSITES

Human papillomavirus infection is now a well-established cause of many common cancers like cervical, other anogenital, and head and neck cancers. The mortality and morbidity rate associated with these cancers constitute a major burden especially for the underdeveloped and developing countries of the world, where they are more common. Traditionally, all these subsites are being treated with different chemoradiation protocols with variable results. Toxicities associated with the standard high dose chemoradiation protocols form a major obstacle in the completion of treatment for these patients and often affects the outcome negatively. Personal experience and published reports and reviews suggests that HPV associated squamous cell cancers are a distinct biological sub group of cancer which can be treated safely with reduced intensity of chemoradiation. The establishment of a similar de-intensified chemoradiation protocol for all HPV associated squamous cell carcinoma will certainly improve the quality of life of such patients.