ArticleCancer2018
Associations among human papillomavirus, inflammation, and fatigue in patients with head and neck cancer.
Article in Cancer, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 3 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Inflammatory Correlates and Prospective Associations of Cancer-Related Fatigue: A Systematic Review and Meta-Analysis.Psycho-oncology · 2026Pooled it
- The changing face of head and neck cancer: are patients with human papillomavirus-positive disease at greater nutritional risk? A systematic review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022Pooled it
- Symptom Clusters in Head and Neck Cancer: A Systematic Review and Conceptual Model.Seminars in oncology nursing · 2021Pooled it
- Depressive symptoms and perceived stress in patients with head and neck cancer undergoing intensity-modulated radiation therapy: A longitudinal study.European journal of oncology nursing : the official journal of European Oncology Nursing Society · 2026Article
- Cancer-related pain in head and neck cancer survivors: longitudinal findings from the Head and Neck 5000 clinical cohort.Journal of cancer survivorship : research and practice · 2025Article
- Prevalence and Correlates of Depression and Anxiety Among Women with HPV-Related Cervical Disease: A Hospital-Based Cross-Sectional Study in Shenzhen, China.International journal of women's health · 2025Article
- ACTivity as medicine In Oncology for Head and Neck (ACTIOHN): a feasibility study investigating a patient-centred approach to exercise for head and neck cancer patients.Frontiers in oncology · 2025Article
- Type I interferons, inflammation, and fatigue in a longitudinal RNA study of women with breast cancer.Brain, behavior, and immunity · 2024Article
- Article
- Determinants of the level of circulating-tumor HPV16 DNA in patients with HPV-associated oropharyngeal cancer at the time of diagnosis.Scientific reports · 2023Article
- Associations of the gut microbiome with psychoneurological symptom cluster in women with gynecologic cancers: a longitudinal study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023Article
- Article
- Longitudinal associations among physical activity, inflammatory markers, and quality of life in patients with head and neck cancer.Head & neck · 2023Observational
- Associations of inflammation with neuropsychological symptom cluster in patients with Head and neck cancer: A longitudinal study.Brain, behavior, & immunity - health · 2023Article
- Patient-Reported Outcome Measures of Psychosocial Quality of Life in Oropharyngeal Cancer Patients: A Scoping Review.Journal of clinical medicine · 2023Article
- Review
- Risk factors associated with patient-reported fatigue among long-term oropharyngeal carcinoma survivors.Head & neck · 2022Article
- Neuroimmunology of cancer and associated symptomology.Immunology and cell biology · 2021Review
- Association of Epigenetic Age Acceleration With Risk Factors, Survival, and Quality of Life in Patients With Head and Neck Cancer.International journal of radiation oncology, biology, physics · 2021Article
- Phytochemicals as Potential Chemopreventive and Chemotherapeutic Agents for Emerging Human Papillomavirus-Driven Head and Neck Cancer: Current Evidence and Future Prospects.Frontiers in pharmacology · 2021Review
Corrections and comments
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Authors and funding
12 authors at 1 institution in 1 country.
Funding
Abstract
backgroundHuman papillomavirus (HPV) infection has contributed to an increased incidence of squamous cell carcinoma of the head and neck (SCCHN). Fatigue is a major side effect of SCCHN and its treatment. However, to the authors' knowledge, the association between HPV and fatigue has not been examined to date, nor is it known whether HPV influences biological mechanisms of fatigue, including inflammation.
methodsPatients with SCCHN who were without distant metastasis were assessed at baseline (pre-radiotherapy) and 1 month and 3 months postradiotherapy. Fatigue was measured using the Multidimensional Fatigue Inventory. Peripheral inflammation was assessed by plasma C-reactive protein (CRP), interleukin 1 receptor antagonist (IL-1ra), soluble tumor necrosis factor receptor 2 (sTNFR2), and IL-6. Mixed effect models were used to examine associations.
resultsA total of 94 patients who were newly diagnosed were enrolled; 53% had HPV-related tumors. Patients with HPV-unrelated tumors had higher fatigue and higher plasma CRP, sTNFR2, and IL-6 over time, especially at baseline and 3 months after intensity-modulated radiotherapy compared with those with HPV-related tumors (all P < .05). However, fatigue and plasma sTNFR2 increased more significantly from baseline to 1 month after radiotherapy in the HPV-related group compared with the HPV-unrelated group (both P < .01). Controlling for significant covariates, HPV status and inflammation were found to be independent predictors of fatigue over time.
conclusionsHPV status is an important marker of vulnerability to the behavioral and immune consequences of SCCHN and its treatment, providing support for different symptom management strategies. Special emphasis should be placed on addressing marked persistent fatigue in patients with HPV-unrelated tumors, whereas attention should be paid to the large increases in fatigue during treatment among patients with HPV-related tumors. Cancer 2018. © 2018 American Cancer Society.
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