Tumor volume as prognostic factor in chemoradiation for advanced head and neck cancer.
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.
Knegjens
Joost L
JL
Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. j.knegjens@nki.nl
Hauptmann
Michael
M
Pameijer
Frank A
FA
Balm
Alfons J
AJ
Hoebers
Frank J
FJ
de Bois
Josien A
JA
Kaanders
Johannes H
JH
van Herpen
Carla M
CM
Verhoef
Cornelia G
CG
Wijers
Oda B
OB
Wiggenraad
Ruud G
RG
Buter
Jan
J
Rasch
Coen R
CR
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*