Skip to main content
SpringerLink
Log in

Factors Affecting Response and Survival in Radiotherapy

  • Chapter
  • First Online:
Improving Outcomes in Oral Cancer

  • 510 Accesses

Abstract

We are investigating the different variables that can potentially affect tumor response to radiation therapy. These factors can be tumor-specific, patient-specific, therapy-specific, or a combination of these variables. Noteworthy factors include extranodal extension, tumor microenvironment, time to adjunctive radiation therapy, tumor volume, margin status, adjunctive concurrent chemotherapy, and fractionation schedule/dose. This chapter sheds light on how the previously mentioned factors can potentially impact the efficacy of radiation treatment on locoregional recurrence, overall survival, and disease-free specific survival as a treatment modality for oral cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Lavaf A, et al. Adjuvant radiotherapy improves overall survival for patients with lymph node-positive head and neck squamous cell carcinoma. Cancer. 2008;112(3):535–43.

    Article  PubMed  Google Scholar 

  2. Kao J, et al. Adjuvant radiotherapy and survival for patients with node-positive head and neck cancer: an analysis by primary site and nodal stage. Int J Radiat Oncol Biol Phys. 2008;71(2):362–70.

    Article  PubMed  Google Scholar 

  3. Sanguineti G, Forastiere AA. Determining the survival benefit of adjuvant radiotherapy in patients with node-positive head and neck cancer. Nat Clin Pract Oncol. 2008;5:694.

    Article  PubMed  Google Scholar 

  4. Perri F, et al. Radioresistance in head and neck squamous cell carcinoma: biological bases and therapeutic implications. Head Neck. 2015;37(5):763–70.

    Article  PubMed  Google Scholar 

  5. Silva P, et al. Clinical and biological factors affecting response to radiotherapy in patients with head and neck cancer: a review. Clin Otolaryngol. 2007;32(5):337–45.

    Article  PubMed  Google Scholar 

  6. Nordsmark M, Overgaard J. A confirmatory prognostic study on oxygenation status and loco-regional control in advanced head and neck squamous cell carcinoma treated by radiation therapy. Radiother Oncol. 2000;57(1):39–43.

    Article  PubMed  Google Scholar 

  7. Allal AS, et al. Standardized uptake value of 2-[18F] fluoro-2-deoxy-d-glucose in predicting outcome in head and neck carcinomas treated by radiotherapy with or without chemotherapy. J Clin Oncol. 2002;20(5):1398–404.

    Article  PubMed  Google Scholar 

  8. La TH, et al. Metabolic tumor volume predicts for recurrence and death in head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2009;74(5):1335–41.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Jeong J, et al. Estimate of the impact of FDG-avidity on the dose required for head and neck radiotherapy local control. Radiother Oncol. 2014;111(3):340–7.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Buffa FM, et al. Molecular marker profiles predict locoregional control of head and neck squamous cell carcinoma in a randomized trial of continuous hyperfractionated accelerated radiotherapy. Clin Cancer Res. 2004;10(11):3745–54.

    Article  PubMed  Google Scholar 

  11. Begg AC. Predicting recurrence after radiotherapy in head and neck cancer. Semin Radiat Oncol. 2012;22(2):108–18.

    Article  PubMed  Google Scholar 

  12. Alsner J, Sorensen SB, Overgaard J. TP53 mutation is related to poor prognosis after radiotherapy, but not surgery, in squamous cell carcinoma of the head and neck. Radiother Oncol. 2001;59(2):179–85.

    Article  PubMed  Google Scholar 

  13. Somers KD, et al. Frequent p53 mutations in head and neck cancer. Cancer Res. 1992;52(21):5997–6000.

    PubMed  Google Scholar 

  14. Csuka O, et al. Predictive value of p53, Bcl2 and bax in the radiotherapy of head and neck cancer. Pathol Oncol Res. 1997;3(3):204–10.

    Article  PubMed  Google Scholar 

  15. Haffty BG, Glazer PM. Molecular markers in clinical radiation oncology. Oncogene. 2003;22(37):5915–25.

    Article  PubMed  Google Scholar 

  16. Sittel C, et al. Prognostic significance of Ki-67 (MIB1), PCNA and p53 in cancer of the oropharynx and oral cavity. Oral Oncol. 1999;35(6):583–9.

    Article  PubMed  Google Scholar 

  17. Jacob R, et al. Heterogeneity of squamous cell carcinomas of the head and neck-analysis of tumor biologic factors and proliferation rates. Laryngoscope. 1996;106(9):1170–5.

    Article  PubMed  Google Scholar 

  18. Raybaud H, et al. Nuclear DNA content, an adjunct to p53 and Ki-67 as a marker of resistance to radiation therapy in oral cavity and pharyngeal squamous cell carcinoma. Int J Oral Maxillofac Surg. 2000;29(1):36–41.

    Article  PubMed  Google Scholar 

  19. Ang KK, et al. Impact of epidermal growth factor receptor expression on survival and pattern of relapse in patients with advanced head and neck carcinoma. Cancer Res. 2002;62(24):7350–6.

    PubMed  Google Scholar 

  20. Fu KK, et al. A Radiation Therapy Oncology Group (RTOG) phase III randomized study to compare hyperfractionation and two variants of accelerated fractionation to standard fractionation radiotherapy for head and neck squamous cell carcinomas: first report of RTOG 9003. Int J Radiat Oncol Biol Phys. 2000;48(1):7–16.

    Article  PubMed  Google Scholar 

  21. Ho AS, et al. Quantitative survival impact of composite treatment delays in head and neck cancer. Cancer. 2018;124(15):3154–62.

    Article  PubMed  Google Scholar 

  22. Overgaard J, et al. Five compared with six fractions per week of conventional radiotherapy of squamous-cell carcinoma of head and neck: DAHANCA 6 and 7 randomised controlled trial. Lancet. 2003;362(9388):933–40.

    Article  PubMed  Google Scholar 

  23. González Ferreira JA, et al. Effect of radiotherapy delay in overall treatment time on local control and survival in head and neck cancer: review of the literature. Rep Pract Oncol Radiother. 2015;20(5):328–39.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Harris JP, et al. Association of survival with shorter time to radiation therapy after surgery for US patients with head and neck cancer. JAMA Otolaryngol Head Neck Surg. 2018;144(4):349–59.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Graboyes EM, et al. Effect of time to initiation of postoperative radiation therapy on survival in surgically managed head and neck cancer. Cancer. 2017;123(24):4841–50.

    Article  PubMed  Google Scholar 

  26. Sanguineti G, et al. Accelerated versus conventional fractionated postoperative radiotherapy for advanced head and neck cancer: results of a multicenter phase III study. Int J Radiat Oncol Biol Phys. 2005;61(3):762–71.

    Article  PubMed  Google Scholar 

  27. Lacas B, et al. Role of radiotherapy fractionation in head and neck cancers (MARCH): an updated meta-analysis. Lancet Oncol. 2017;18(9):1221–37.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Baujat B, et al. Hyperfractionated or accelerated radiotherapy for head and neck cancer. Cochrane Database Syst Rev. 2010;12:Cd002026.

    Google Scholar 

  29. Radoi L, Luce D. A review of risk factors for oral cavity cancer: the importance of a standardized case definition. Community Dent Oral Epidemiol. 2013;41(2):97–109, e78–91.

    Article  PubMed  Google Scholar 

  30. Browman GP, et al. Influence of cigarette smoking on the efficacy of radiation therapy in head and neck cancer. N Engl J Med. 1993;328(3):159–63.

    Article  PubMed  Google Scholar 

  31. Chen AM, et al. Tobacco smoking during radiation therapy for head-and-neck cancer is associated with unfavorable outcome. Int J Radiat Oncol Biol Phys. 2011;79(2):414–9.

    Article  PubMed  Google Scholar 

  32. Rabinovitch R, et al. Impact of nutrition support on treatment outcome in patients with locally advanced head and neck squamous cell cancer treated with definitive radiotherapy: a secondary analysis of RTOG trial 90-03. Head Neck. 2006;28(4):287–96.

    Article  PubMed  Google Scholar 

  33. Pai PC, et al. Impact of pretreatment body mass index on patients with head-and-neck cancer treated with radiation. Int J Radiat Oncol Biol Phys. 2012;83(1):e93–e100.

    Article  PubMed  Google Scholar 

  34. Amit M, et al. Improvement in survival of patients with oral cavity squamous cell carcinoma: an international collaborative study. Cancer. 2013;119(24):4242–8.

    Article  PubMed  Google Scholar 

  35. Zhang H, et al. Survival outcomes of patients with advanced oral cavity squamous cell carcinoma treated with multimodal therapy: a multi-institutional analysis. J Otolaryngol Head Neck Surg. 2013;42:30.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Iyer NG, et al. Randomized trial comparing surgery and adjuvant radiotherapy versus concurrent chemoradiotherapy in patients with advanced, nonmetastatic squamous cell carcinoma of the head and neck: 10-year update and subset analysis. Cancer. 2015;121(10):1599–607.

    Article  PubMed  Google Scholar 

  37. Daly ME, et al. Intensity-modulated radiotherapy for oral cavity squamous cell carcinoma: patterns of failure and predictors of local control. Int J Rad Oncol Biol Phys. 2011;80(5):1412–22.

    Article  Google Scholar 

  38. Parsons JT, et al. An analysis of factors influencing the outcome of postoperative irradiation for squamous cell carcinoma of the oral cavity. Int J Radiat Oncol Biol Phys. 1997;39(1):137–48.

    Article  PubMed  Google Scholar 

  39. Hinerman RW, et al. Postoperative irradiation for squamous cell carcinoma of the oral cavity: 35-year experience. Head Neck. 2004;26(11):984–94.

    Article  PubMed  Google Scholar 

  40. Bernier J, et al. Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med. 2004;350(19):1945–52.

    Article  PubMed  Google Scholar 

  41. Ooishi M, et al. Patterns of failure after postoperative intensity-modulated radiotherapy for locally advanced and recurrent head and neck cancer. Jpn J Clin Oncol. 2016;46(10):919–27.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, North Memorial Medical Center, Minneapolis, MN, USA

    Michael Awadallah & Ketan J. Patel

  2. Minneapolis Radiation Oncology, Minneapolis, MN, USA

    Kurt Nisi

Authors
  1. Michael Awadallah
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kurt Nisi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ketan J. Patel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Michael Awadallah .

Editor information

Editors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, North Memorial Medical Center, Minneapolis, MN, USA

    Deepak Kademani

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Awadallah, M., Nisi, K., Patel, K.J. (2020). Factors Affecting Response and Survival in Radiotherapy. In: Kademani, D. (eds) Improving Outcomes in Oral Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-30094-4_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-30094-4_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-30093-7

  • Online ISBN: 978-3-030-30094-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation