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Tumor volume as a predictive parameter in the sequential therapy (induction chemotherapy) of head and neck squamous cell carcinomas

  • M. BohlenEmail author
  • C. -J. Busch
  • S. Sehner
  • F. Forterre
  • J. Bier
  • C. Berliner
  • L. Bußmann
  • A. Münscher
Head & Neck
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Abstract

Purpose

Tumor volume in locally advanced head and neck squamous cell carcinomas (LAHNSCC) treated by induction chemotherapy (ICT) and followed by radiochemotherapy (RCT) was measured. The presence of potential correlation of initial tumor volume and volume reduction after ICT and RCT with remission status, overall survival (OS) and disease-free survival (DFS) were investigated. Furthermore, reliability of approximation of the tumor volume relying on its diameter to manual three-dimensional measurement was assessed.

Methods

Data of patients with LAHNSCC treated by ICT consisting of docetaxel, cisplatin, and 5-fluorouracil (TPF) followed by definite RCT were retrospectively analyzed. The tumor volume was calculated slice-by-slice in contrast-enhanced CT or MRI before and after ICT as well as after complete treatment. The volume was compared to radiologic remission status, correlated with OS and DFS, and to volume estimation using tumor diameter.

Result

65 patients were included. Primary tumor volume did not correlate with complete remission rate (CR) after ICT and RCT, OS or DFS. The change in tumor volume between baseline imaging and post-RCT had a significant impact on OS (p = 0.026) and DFS (p = 0.028). The agreement between tumor volume and radiologic remission was 72.14%.

Conclusion

The initial tumor volume had no influence on CR, OS or DFS. A severe response to ICT did not predict a powerful RCT outcome. The change in tumor volume post-RCT had an impact on OS and DFS. Tumor volume estimation using its diameter seems to be a reliable method.

Keywords

Head and neck neoplasms Induction chemotherapy Remission status Treatment outcome 
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Notes

Funding

This study was not funded by any grant.

Compliance with ethical standards

Conflict of interest

M. Bohlen declares that she has no conflict of interest. CJ Busch declares that she has no conflict of interest. S. Sehner declares that she has no conflict of interest. F. Forterre declares that he has no conflict of interest. JC. Bier declares that he has no conflict of interest. C. Berliner declares that he has no conflict of interest. L. Bussmann declares that she has no conflict of interest. A. Münscher declares that he has no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Supplementary material

405_2019_5323_MOESM1_ESM.docx (17 kb)
Supplementary material 1 (DOCX 16 KB)
405_2019_5323_MOESM2_ESM.docx (13 kb)
Supplementary material 2 (DOCX 12 KB)

References

  1. 1.
    Ferlay J, Soerjomataram I, Dikshit R et al (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136(5):E359–E386CrossRefGoogle Scholar
  2. 2.
    Colevas AD, Yom SS, Pfister DG et al (2018) NCCN guidelines insights: head and neck cancers, version 1.2018. J Natl Compr Canc Netw 16(5):479–490CrossRefGoogle Scholar
  3. 3.
    Forastiere AA, Adelstein DJ, Manola J (2013) Induction chemotherapy meta-analysis in head and neck cancer: right answer, wrong question. J Clin Oncol 31(23):2844–2846CrossRefGoogle Scholar
  4. 4.
    Ghi MG, Paccagnella A, Ferrari D et al (2017) Induction TPF followed by concomitant treatment versus concomitant treatment alone in locally advanced head and neck cancer. A phase II-III trial. Ann Oncol 28(9):2206–2212Google Scholar
  5. 5.
    Lorch JH, Goloubeva O, Haddad RI et al (2011) Induction chemotherapy with cisplatin and fluorouracil alone or in combination with docetaxel in locally advanced squamous-cell cancer of the head and neck: long-term results of the TAX 324 randomised phase 3 trial. Lancet Oncol 12(2):153–159CrossRefGoogle Scholar
  6. 6.
    van Herpen CM, Mauer ME, Mesia R et al (2010) Short-term health-related quality of life and symptom control with docetaxel, cisplatin, 5-fluorouracil and cisplatin (TPF), 5-fluorouracil (PF) for induction in unresectable locoregionally advanced head and neck cancer patients (EORTC 24971/TAX 323). Br J Cancer 103(8):1173–1181CrossRefGoogle Scholar
  7. 7.
    Kurek R, Kalogera-Fountzila A, Muskalla K et al (2003) Usefulness of tumor volumetry as a prognostic factor of survival in head and neck cancer. Strahlenther Onkol 179(5):292–297CrossRefGoogle Scholar
  8. 8.
    Knegjens JL, Hauptmann M, Pameijer FA et al (2011) Tumor volume as prognostic factor in chemoradiation for advanced head and neck cancer. Head Neck 33(3):375–382Google Scholar
  9. 9.
    Dejaco D, Steinbichler T, Schartinger VH et al (2018) Prognostic value of tumor volume in patients with head and neck squamous cell carcinoma treated with primary surgery. Head Neck 40(4):728–739CrossRefGoogle Scholar
  10. 10.
    Kimura Y, Sumi M, Ichikawa Y, Kawai Y, Nakamura T (2005) Volumetric MR imaging of oral, maxillary sinus, oropharyngeal, and hypopharyngeal cancers: correlation between tumor volume and lymph node metastasis. AJNR 26(9):2384–2389Google Scholar
  11. 11.
    Rutkowski T, Wygoda A, Skladowski K et al (2013) Prognostic role of tumor volume for radiotherapy outcome in patient with T2 laryngeal cancer. Strahlenther Onkol 189(10):861–866CrossRefGoogle Scholar
  12. 12.
    Lok BH, Setton J, Caria N et al (2012) Intensity-modulated radiation therapy in oropharyngeal carcinoma: effect of tumor volume on clinical outcomes. Int J Radiat Oncol Biol Phys 82(5):1851–1857CrossRefGoogle Scholar
  13. 13.
    Mayr NA, Taoka T, Yuh WT et al (2002) Method and timing of tumor volume measurement for outcome prediction in cervical cancer using magnetic resonance imaging. Int J Radiat Oncol Biol Phys 52(1):14–22CrossRefGoogle Scholar
  14. 14.
    Sorensen AG, Patel S, Harmath C et al (2001) Comparison of diameter and perimeter methods for tumor volume calculation. J Clin Oncol 19(2):551–557CrossRefGoogle Scholar
  15. 15.
    Dejaco D, Url C, Schartinger VH et al (2015) Approximation of head and neck cancer volumes in contrast enhanced CT. Cancer Imaging 15:16CrossRefGoogle Scholar
  16. 16.
    Baghi M, Mack MG, Hambek M et al (2007) Usefulness of MRI volumetric evaluation in patients with squamous cell cancer of the head and neck treated with neoadjuvant chemotherapy. Head Neck 29(2):104–108CrossRefGoogle Scholar
  17. 17.
    Strongin A, Yovino S, Taylor R et al (2012) Primary tumor volume is an important predictor of clinical outcomes among patients with locally advanced squamous cell cancer of the head and neck treated with definitive chemoradiotherapy. Int J Radiat Oncol Biol Phys 82(5):1823–1830CrossRefGoogle Scholar
  18. 18.
    Gray LH, Conger AD, Ebert M, Hornsey S, Scott OC (1953) The concentration of oxygen dissolved in tissues at the time of irradiation as a factor in radiotherapy. Br J Radiol 26(312):638–648CrossRefGoogle Scholar
  19. 19.
    Johnson CR, Thames HD, Huang DT, Schmidt-Ullrich RK (1995) The tumor volume and clonogen number relationship: tumor control predictions based upon tumor volume estimates derived from computed tomography. Int J Radiat Oncol Biol Phys 33(2):281–287CrossRefGoogle Scholar
  20. 20.
    Posner MR, Glisson B, Frenette G et al (2001) Multicenter phase I-II trial of docetaxel, cisplatin, and fluorouracil induction chemotherapy for patients with locally advanced squamous cell cancer of the head and neck. J Clin Oncol 19(4):1096–1104CrossRefGoogle Scholar
  21. 21.
    Dietz A, Rudat V, Dreyhaupt J et al (2009) Induction chemotherapy with paclitaxel and cisplatin followed by radiotherapy for larynx organ preservation in advanced laryngeal and hypopharyngeal cancer offers moderate late toxicity outcome (DeLOS-I-trial). Eur Arch Otorhinolaryngol 266(8):1291–1300CrossRefGoogle Scholar
  22. 22.
    Lefebvre JL, Pointreau Y, Rolland F et al (2013) Induction chemotherapy followed by either chemoradiotherapy or bioradiotherapy for larynx preservation: the TREMPLIN randomized phase II study. J Clin Oncol 31(7):853–859CrossRefGoogle Scholar
  23. 23.
    Haddad R, O’Neill A, Rabinowits G et al (2013) Induction chemotherapy followed by concurrent chemoradiotherapy (sequential chemoradiotherapy) versus concurrent chemoradiotherapy alone in locally advanced head and neck cancer (PARADIGM): a randomised phase 3 trial. Lancet Oncol 14(3):257–264CrossRefGoogle Scholar
  24. 24.
    Hitt R, Grau JJ, Lopez-Pousa A et al (2014) A randomized phase III trial comparing induction chemotherapy followed by chemoradiotherapy versus chemoradiotherapy alone as treatment of unresectable head and neck cancer. Ann Oncol 25(1):216–225CrossRefGoogle Scholar
  25. 25.
    Forastiere AA, Zhang Q, Weber RS et al (2013) Long-term results of RTOG 91-11: a comparison of three nonsurgical treatment strategies to preserve the larynx in patients with locally advanced larynx cancer. J Clin Oncol 31(7):845–852CrossRefGoogle Scholar
  26. 26.
    Prochnow S, Wilczak W, Bosch V, Clauditz TS, Muenscher A (2018) ERCC1, XPF and XPA-locoregional differences and prognostic value of DNA repair protein expression in patients with head and neck squamous cell carcinoma. Clin Oral Investig 1:1Google Scholar
  27. 27.
    Nienstedt JC, Grobe A, Clauditz T et al (2017) High-level betaIII-tubulin overexpression occurs in most head and neck cancers but is unrelated to clinical outcome. J Oral Pathol Med 46(10):986–990Google Scholar
  28. 28.
    Nienstedt JC, Schroeder C, Clauditz T et al (2018) EZH2 overexpression in head and neck cancer is related to lymph node metastasis. J Oral Pathol Med 47(3):240–245CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Otorhinolaryngology, Head and Neck Surgery and OncologyUniversity Medical Center Hamburg-EppendorfHamburgGermany
  2. 2.Department of Medical Biometry and EpidemiologyUniversity Medical Center Hamburg-EppendorfHamburgGermany
  3. 3.Department of Veterinary Medicine, Small Animal SurgeryVetsuisse Faculty BernBernSwitzerland
  4. 4.Department of Diagnostic and Interventional Radiology and Nuclear MedicineUniversity Medical Center Hamburg-EppendorfHamburgGermany

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