Xiao C, et al. - Researchers investigated the link between human papillomavirus (HPV) and fatigue and if HPV impacts biological mechanisms of fatigue, including inflammation in patients with squamous cell carcinoma of the head and neck (SCCHN). Different symptom management strategies for these patients were supported by the finding that HPV status represents an important marker of vulnerability to the behavioral and immune consequences of SCCHN and its treatment. Obvious persistent fatigue in patients with HPV-unrelated tumors should be especially addressed. Clinicians should focus on large increases in fatigue during treatment among patients with HPV-related tumors.

Methods

• Researchers examined patients with SCCHN who were without distant metastasis at baseline (pre-radiotherapy) and 1 month and 3 months postradiotherapy.
• They used the Multidimensional Fatigue Inventory to measure fatigue.
• Plasma C-reactive protein (CRP), interleukin 1 receptor antagonist (IL-1ra), soluble tumor necrosis factor receptor 2 (sTNFR2), and IL-6 were analyzed to assess peripheral inflammation.
• They used mixed effect models to assess associations.

Results

• They enrolled a total of 94 patients who were newly diagnosed; HPV-related tumors were present in 53%.
• Higher fatigue and higher plasma CRP, sTNFR2, and IL-6 over time, especially at baseline and 3 months after intensity-modulated radiotherapy, were observed among patients with HPV-unrelated tumors vs those with HPV-related tumors (all P < .05).
• However, HPV-related group vs the HPV-unrelated group (both P < .01) showed a more significant increase in fatigue and plasma sTNFR2 from baseline to 1 month after radiotherapy.
• HPV status and inflammation were identified as independent predictors of fatigue over time, controlling for significant covariates.