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Tumor volume as prognostic factor in chemoradiation for advanced head and neck cancer
Author(s) -
Knegjens Joost L.,
Hauptmann Michael,
Pameijer Frank A.,
Balm Alfons J.,
Hoebers Frank J.,
de Bois Josien A.,
Kaanders Johannes H.,
van Herpen Carla M.,
Verhoef Cornelia G.,
Wijers Oda B.,
Wiggenraad Ruud G.,
Buter Jan,
Rasch Coen R.
Publication year - 2011
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.21459
Subject(s) - medicine , head and neck squamous cell carcinoma , head and neck cancer , primary tumor , oncology , concomitant , hazard ratio , chemoradiotherapy , radiation therapy , multivariate analysis , cancer , nuclear medicine , confidence interval , metastasis
Abstract Background Tumor volume is an important predictor of outcome in radiotherapy alone. Its significance in concomitant chemoradiation (CCRT) is much less clear. We analyzed the prognostic value of primary tumor volume for advanced head and neck squamous cell carcinoma (HNSCC) treated with CCRT. Methods Three hundred sixty patients treated with definitive CCRT for advanced HNSCC were selected. The pretreatment MRI or CT scan was used to calculate the primary tumor volume. Median follow‐up was 19.8 months. Results The average primary tumor volume was 37.0 cm 3 (range, 2.1–182.7 cm 3 ; median, 28.7 cm 3 ). Multivariate analysis showed a significant effect of tumor volume on local control. The hazard ratio for a local recurrence increased by 14% per 10 cm 3 volume increase (95% CI, 8% to 21%). There was no significant independent effect of T and N status on local control. Conclusion For advanced HNSCC, tumor volume is more powerful for predicting outcome after CCRT than TNM status. © 2010 Wiley Periodicals, Inc. Head Neck, 2010