Fulltext

Volumetric stratification of cT4 stage head and neck cancer = Volumetrische Stratifizierung von Kopf-Hals-Tumoren im cT4-Stadium

Studer, G. ; Glanzmann, C.

In: Strahlentherapie und Onkologie, 2013, vol. 189, no. 10, p. 867-873

Ajouter à la liste personnelle
    Titre
    • Volumetric stratification of cT4 stage head and neck cancer
    Titre traduit ()
    • Volumetrische Stratifizierung von Kopf-Hals-Tumoren im cT4-Stadium
    Auteur
    • Studer, G.. Department of Radiation Oncology, University Hospital Zurich, Raemistr. 100, 8091, Zurich, Switzerland
    • Glanzmann, C.. Department of Radiation Oncology, University Hospital Zurich, Raemistr. 100, 8091, Zurich, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Strahlentherapie und Onkologie, 2013, vol. 189, no. 10, p. 867-873. Springer Berlin Heidelberg
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:310036
    Summary
    Background: Locoregionally advanced stage head and neck cancer (HNC) is known for unfavorable outcome with only ~ 40-50 % 3-year overall survival (OS). Clinical T4 stage includes a wide range of tumor burden. The lack of further nonsurgical subgrouping of cT4 stage makes intercenter outcome of irradiated cohorts difficult. Aim of this analysis was to further stratify cT4 stage HNC using volumetric staging. Material and methods: Between January 2002 and January 2013, a total of 201 cT4 stage squamous cell cancer (SCC) HNC patients referred to our center for curative definitive radiation were consecutively irradiated. Radiation was performed using modulated techniques. Total gross tumor volumes (tGTV: primary + nodal tumor volume) of all patients have retrospectively been stratified using a prospectively evaluated volumetric staging system which bases on 3 cut-offs (15/70/130ml), translating into 4 prognostic subgroups [V1: 1-15ml (n = 15), V2: 16-70ml (108), V3: 71-130ml (62), V4: > 130ml (16)]. OS, disease-free survival (DFS), locoregional control (LRC), and distant metastasis-free survival (DMFS) rates were calculated. Results: The mean/median follow-up was 31/23months (range 1-116months). The 3-year OS, DFS, LRC, and DMFS rates of the entire cohort were 63, 44, 48, and 77 %, respectively. Volumetric staging revealed its potential to prognostically statistically significantly divide the cT4 cohort into 4volume subgroups (V1/2/3/4): OS: 90 %/72 %/58 %/18 %; DFS: 83 %/50 %/39 %/10 %; LRC: 81 %/53 %/47 %/15 %; DMFS: 93 %/90 %/70 %/41 %, all p < 0.0001. Conclusion: Volumetric staging allowed a highly statistically significant stratification of cT4 HNC stages into prognostic subgroups, which offers the chance of better intercenter comparability of irradiated advanced stage HNC cohorts