title: Volumetric staging in oropharyngeal cancer patients treated with definitive IMRT.
abstract: BACKGROUND
  The superiority of volumetric staging (VS) over TNM/TNM-grouping system was previously prospectively tested in our head neck cancer population treated with intensity-modulated radiotherapy (IMRT); gross tumor volume (GTV) was the strongest predictor for disease control. Aim of this work was to specifically assess the prognostic value of VS in oropharyngeal cancer (OC).
  
  
  METHODS
  Between 04/2002 and 12/2011, 277 consecutive OC patients underwent definitive IMRT. Mean/median follow-up was 33/27 months (3-113). Three volumetric cut-offs were used (resulting in 4 GTV subgroups: 1-15 cc (14%), 16-70 cc (62%), 71-130 cc (20%), >130 cc (4%)).
  
  
  METHODS
  Outcome in the OC subgroup was prospectively assessed with VS and compared with that resulting from TNM and AJCC staging.
  
  
  RESULTS
  Primary GTV was most reliably predicting local control (p<0.0001), all other outcome parameters were predicted best by the total GTV (p<0.0001).
  
  
  CONCLUSIONS
  This is -to our knowledge- the first volumetric staging system for OC, and was found to be most reliable in predicting outcome in OC patients treated with IMRT.
authors.affiliation: Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland. gabriela.studer@usz.ch
authors.forename: Gabriela
authors.initials: G
authors.lastname: Studer
authors.forename: Christoph
authors.initials: C
authors.lastname: Glanzmann
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000532:radiotherapy / Q000556:secondary; D000068818:Cetuximab; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging / Q000379:methods; D009959:Oropharyngeal Neoplasms / Q000473:pathology* / Q000532:radiotherapy; D010157:Palatal Neoplasms / Q000473:pathology / Q000532:radiotherapy; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D015203:Reproducibility of Results; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D014062:Tongue Neoplasms / Q000473:pathology / Q000532:radiotherapy; D014067:Tonsillar Neoplasms / Q000473:pathology / Q000532:radiotherapy; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000068818:Cetuximab; D002945:Cisplatin