title: Tumor volume as prognostic factor in chemoradiation for advanced head and neck cancer.
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 cm³ (range, 2.1-182.7 cm³; median, 28.7 cm³). Multivariate analysis showed a significant effect of tumor volume on local control. The hazard ratio for a local recurrence increased by 14% per 10 cm³ volume increase (95% CI, 8% to 21%). There was no significant independent effect of T and N status on local control.
  
  
  CONCLUSIONS
  For advanced HNSCC, tumor volume is more powerful for predicting outcome after CCRT than TNM status.
authors.affiliation: Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. j.knegjens@nki.nl
authors.forename: Joost L
authors.initials: JL
authors.lastname: Knegjens
authors.forename: Michael
authors.initials: M
authors.lastname: Hauptmann
authors.forename: Frank A
authors.initials: FA
authors.lastname: Pameijer
authors.forename: Alfons J
authors.initials: AJ
authors.lastname: Balm
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Hoebers
authors.forename: Josien A
authors.initials: JA
authors.lastname: de Bois
authors.forename: Johannes H
authors.initials: JH
authors.lastname: Kaanders
authors.forename: Carla M
authors.initials: CM
authors.lastname: van Herpen
authors.forename: Cornelia G
authors.initials: CG
authors.lastname: Verhoef
authors.forename: Oda B
authors.initials: OB
authors.lastname: Wijers
authors.forename: Ruud G
authors.initials: RG
authors.lastname: Wiggenraad
authors.forename: Jan
authors.initials: J
authors.lastname: Buter
authors.forename: Coen R
authors.initials: CR
authors.lastname: Rasch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011788:Quality of Life; D011882:Radiotherapy, High-Energy / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D047368:Tumor Burden / Q000187:drug effects* / Q000528:radiation effects*