title: Prognostic role of tumor volume for radiotherapy outcome in patient with T2 laryngeal cancer.
abstract: OBJECTIVE
  Tumor volume (TV) is recognized as a prognostic factor of treatment outcome for head and neck tumors but is not routinely included in the treatment decision-making process. The purpose of the study was to define its prognostic role for patients with T2 laryngeal cancer.
  
  
  METHODS
  TV of 160 patients who underwent RT between 2002 and 2006 for T2 laryngeal squamous cell carcinoma were reviewed. The tumor was located in the glottis and epiglottis in 82 (51%) and 78 (49%) patients, respectively. TV was manually contoured on pretreatment, planning, contrast-enhanced CT scans and the volumetric measurement (cm3) was calculated by the volume algorithm.
  
  
  RESULTS
  The median TV value was 2.01 cm3 (range 0.15-21.68 cm3). The median TV was significantly lower in patients with glottic tumors (p<0.0001), N0 (p<0.001), or well histopatologically differentiated tumors (p=0.01). A significant correlation between TV, hemoglobin concentration (p<0.01), and total dose (TD; p<0.001) was observed. On univariate analyses, TV influenced local control (LC; p=0.02) and overall survival (OS, p<0.001). On multivariate analysis, both age (HR 1.038, p=0.03) and TV (HR=1.075, p=0.01) remained significantly related to LC and OS (age: HR 1.038, p=0.005; TV: HR 1.097, p=0.0001).
  
  
  CONCLUSIONS
  Large TV worsen prognosis of patients with T2 laryngeal cancer. A large TV is more common for supraglottic, poorly differentiated tumors and may suggest higher risk of nodal spread. The routine estimation of TV prior to therapy may be essential in order to select the best treatment option for patients with T2 laryngeal cancer.
authors: Department of Radiation Oncology, Maria Sklodowska-Curie Memorial Cancer Center and the Institute of Oncology, Branch in Gliwice, Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland, tomr22@tlen.pl.
authors: T
authors: T
authors: Rutkowski
authors: A
authors: A
authors: Wygoda
authors: K
authors: K
authors: Składowski
authors: B
authors: B
authors: Hejduk
authors: R
authors: R
authors: Rutkowski
authors: Z
authors: Z
authors: Kołosza
authors: B
authors: B
authors: Maciejewski
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000706:statistics & numerical data*; D007822:Laryngeal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D011379:Prognosis; D020266:Radiotherapy, Conformal / Q000401:mortality*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D047368:Tumor Burden
references: Ann Oncol. 2013 Jan;24(1):208-14
references: 23002280
references: J Otolaryngol. 2004 Oct;33(5):289-94
references: 15931812
references: Int J Radiat Oncol Biol Phys. 2007 Dec 1;69(5):1389-94
references: 17869013
references: Head Neck. 1996 Jan-Feb;18(1):24-35
references: 8774919
references: Radiother Oncol. 1998 May;47(2):167-74
references: 9683365
references: Laryngoscope. 2005 Aug;115(8):1402-10
references: 16094113
references: Eur J Surg Oncol. 2009 Mar;35(3):223-9
references: 18468836
references: J Nutr. 2002 Nov;132(11 Suppl):3465S-3466S
references: 12421871
references: Ann Otol Rhinol Laryngol. 1987 Sep-Oct;96(5):514-8
references: 3674647
references: Laryngoscope. 2008 Jul;118(7):1180-5
references: 18475213
references: Head Neck. 2007 Feb;29(2):104-8
references: 17111434
references: Oncology (Williston Park). 2005 Mar;19(3):371-9; discussion 380-2, 387
references: 15828552
references: AJNR Am J Neuroradiol. 1995 Apr;16(4):655-62
references: 7611018
references: Strahlenther Onkol. 2012 Aug;188(8):686-91
references: 22729281
references: J Otolaryngol. 1998 Oct;27(5):247-51
references: 9800621
references: Head Neck. 2008 Sep;30(9):1216-23
references: 18642295
references: Int J Radiat Oncol Biol Phys. 1993 Apr 30;26(1):171-9
references: 8482624
references: Clin Exp Otorhinolaryngol. 2009 Jun;2(2):78-84
references: 19565032
references: Head Neck. 2009 Jun;31(6):709-16
references: 19260114
references: Strahlenther Onkol. 2012 Jan;188(1):62-70
references: 22189439
references: Int J Radiat Oncol Biol Phys. 1995 Sep 30;33(2):281-7
references: 7673015
references: Int J Radiat Oncol Biol Phys. 2012 Apr 1;82(5):1823-30
references: 21549516
references: Head Neck. 1997 Jan;19(1):6-13
references: 9030938
references: Strahlenther Onkol. 2003 May;179(5):292-7
references: 12740655
references: Strahlenther Onkol. 2005 Aug;181(8):483-99
references: 16044216
references: Head Neck. 2011 Mar;33(3):375-82
references: 20629076
references: Int J Radiat Oncol Biol Phys. 1986 Apr;12(4):515-21
references: 3700161
references: Int J Radiat Oncol Biol Phys. 1997 Mar 15;37(5):1011-21
references: 9169807
references: Acta Oncol. 2007;46(3):386-94
references: 17450476
references: AJNR Am J Neuroradiol. 2005 Oct;26(9):2384-9
references: 16219850
references: J Clin Oncol. 1999 Feb;17(2):631-7
references: 10080608
references: Acta Radiol Oncol Radiat Phys Biol. 1979;18(6):497-508
references: 543444
references: Eur Arch Otorhinolaryngol. 2012 Mar;269(3):923-9
references: 22116382
references: Int J Radiat Oncol Biol Phys. 1996 Aug 1;36(1):247-51
references: 8823282
references: Head Neck. 2001 Dec;23(12):1031-6
references: 11774387
references: Br J Radiol. 1983 Apr;56(664):251-5
references: 6831148