Induction chemotherapy followed by radiotherapy for larynx preservation in advanced laryngeal and hypopharyngeal cancer: Outcome prediction after one cycle induction chemotherapy by a score based on clinical evaluation, computed tomography-based volumetry and 18F-FDG-PET/CT

Wichmann, Gunnar; Krüger, Anne; Boehm, Andreas; Kolb, Marlen; Hofer, Mathias; Fischer, M; Müller, Stefan; Purz, Sandra; Stumpp, Patrick; Sabri, Osama; Dietz, Andreas; Kluge, Regine

doi:10.1016/j.ejca.2016.11.013

Cited by 36 publications

(51 citation statements)

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“…Very desirable but not at hand is an easy-to-use way to assess the individual patient’s risk attributable to his/her HLA type. As the aggregation of independent risk factors in a score offers a way to abstract from individual risk factors by summarizing only their (potential) impact as Pi ( 20 ), we had the hypothesis that HR for PFS may be useful to construct an HLA-score. Therefore, we newly defined an HLA-score based on published HR from our recent findings in a test cohort (TC) ( 19 ).…”

Section: Introductionmentioning

confidence: 99%

“…Here, we aim to verify a potential impact of the scored HLA traits on PFS of HNSCC and to particularly elucidate, if this HLA-score reliably predicts outcome differences in the context of clinical trials. Hence, low-resolution HLA typing of leukocytes from an independent validation cohort (iVC), 32 laryngeal/hypopharyngeal HNSCC patients treated in the DeLOS-II larynx-organ preservation trial ( 20 , 21 ), was performed. Related to their HLA-scoring the PFS in the iVC was analyzed and confirmed the prognostic value of the HLA-score.…”

Section: Introductionmentioning

confidence: 99%

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Development of a Human Leukocyte Antigen Score to Predict Progression-Free Survival in Head and Neck Squamous Cell Carcinoma Patients

et al. 2018

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BackgroundIn personalized medicine and treatment stratification of head and neck squamous cell carcinoma (HNSCC), the heterogeneous genetic background of patients is not considered. Human leukocyte antigen (HLA) alleles and HLA haplotypes (HLA traits) are linked to development of HNSCC and affect progression-free survival (PFS) of HNSCC patients but most head and neck oncologists are not familiar with HLA typing. Hence, we developed an HLA-score abstracting from complexity of HLA-typing results to facilitate potential use of HLA-associated hazard ratios (HR) for prognostic stratification.MethodsThe HR for PFS of 8 HLA traits shown to be independent predictors (Pi) of PFS in a test cohort (TC) of 90 HNSCC patients were used to build the HLA-score based on the natural logarithm (ln) of the Pi-associated HR. Crude ln-transformed HR of the eight Pi, alleles B*13 (2), B*35 (1), B*51 (2), DQB1*06 (1), homozygous Cw (1), homozygous DRB4 (2), and haplotypes A*01/B*08 (−6) and B*08/C*07 (4), were summed up to yield the individual patient’s HLA-score. Receiver operating characteristic (ROC) and Kaplan–Meier curves were used to proof the suitability of the HLA-score as prognostic marker for PFS. An independent validation cohort (iVC) of 32 patients treated in the larynx-organ preservation trial DeLOS-II was utilized for validation.ResultsThe individual HLA-scores (range −2 to 6) in TC classified HNSCC patients regarding PFS. ROC analysis (area under the curve = 0.750, 95% CI 0.665–0.836; P = 0.0000034) demonstrated an optimum cutoff for the HLA-score at 0.5 (97.9% sensitivity, 34.7% specificity), and 70/90 patients in TC with HLA-score > 0 had significant reduced PFS (P = 0.001). Applying the same classifier (HLA-score > 0) confirmed these findings in the iVC revealing reduced PFS of 25/32 patients (P = 0.040).ConclusionHLA traits constitute critical Pi. Considering the HLA-score may potentially facilitate the use of genetic information from HLA typing for prognostic stratification, e.g., within clinical trials.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Development of a Human Leukocyte Antigen Score to Predict Progression-Free Survival in Head and Neck Squamous Cell Carcinoma Patients

et al. 2018

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“…Currently, in addition to DWI, multiple imaging modalities, including dynamic contrast-enhanced MRI (21), phosphorous MR spectroscopy (22), and fluorine-18-fluorodeoxyglucose positron emission tomography with computed tomography (23) have been used to predict and monitor treatment efficacy in HNSCC patients. The notable advantages of DWI over these other imaging modalities are its simplicity and the fact that the use of contrast agents is not required.…”

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confidence: 99%

Meta‑analysis of diffusion‑weighted imaging for predicting locoregional failure of chemoradiotherapy in patients with head and neck squamous cell carcinoma

et al. 2017

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Abstract. The purpose of this study was to evaluate the accuracy of diffusion-weighted imaging (DWI) for predicting locoregional failure of chemoradiotherapy in patients with head and neck squamous cell carcinoma (HNSCC). A comprehensive search was conducted through the EMBASE, PubMed and Cochrane Library databases for relevant publications. Stata software was used to calculate the pooled sensitivity, specificity, likelihood ratios and diagnostic odds ratios, and to construct a summary receiver operating characteristics (sROC) curve for DWI. A total of 9 studies comprising 421 patients were included. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio were 0.82 [95% confidence interval (CI): 0.72-0.88], 0.70 (95% CI: 0.62-0.77), 2.7 (95% CI: 2.1-3.6), 0.26 (95% CI: 0.17-0.41), and 10.48 (95% CI: 5.35-20.53), respectively. The area under the sROC curve was 0.84 (95% CI: 0.81-0.87). Therefore, DWI appears to be a promising imaging modality for predicting local failure of chemoradiotherapy in patients with HNSCC. IntroductionHead and neck squamous cell carcinoma (HNSCC) accounts for ~3% of all malignancies (1). Currently, chemoradiotherapy (CRT) is considered as a good approach to the treatment of locally advanced HNSCC. However, ~25-30% of patients have local residual disease or develop relapse at the primary or lymph node sites after treatment (2), which represents a challenge in the management of HNSCC. Therefore, there is a need for biomarkers that can provide accurate and timely prediction of therapeutic outcome prior to treatment or in the early stages of treatment, with discontinuation of ineffective approaches and timely application of alternative therapeutic strategies.Recently, diffusion-weighted imaging (DWI) was proposed as an imaging biomarker for predicting treatment outcome in multiple malignancies, including rectal cancer (3), breast cancer (4) and glioblastoma (5). DWI quickly measures the Brownian motion of extracellular water molecules in biological tissues, which may be quantified with the apparent diffusion coefficient (ADC) (6). Previous studies demonstrated that higher pretreatment ADCs were correlated with poor response to treatment (7,8). In addition, due to its ability to depict the range of ADCs, ADC histograms may be used to evaluate the heterogeneity of the whole tumor. This feature enables evaluation of the degree of necrosis and viability, which may be crucial when planning a radiation dose boost (9).Over the past few years, a number of studies have investigated the role of DWI in predicting response to CRT in patients with HNSCC. Given the varied characteristics of the patients and studies, individual studies are unable to provide a reliable estimate of DWI performance for the prediction of treatment response. Hence, the present meta-analysis was performed to determine the diagnostic performance of DWI for the prediction of locoregional failure of CRT in patients with HNSCC, which may be helpful in optimizing the managem...

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“…T3-Tumoren eine primäre Radiochemotherapie empfohlen [8]. Der Larynxorganerhalt ist bei fortgeschrittenen HNSCC auch bei T4-Larynxkarzinomen über Induktionschemotherapie gefolgt von IMRT möglich, sofern ein gutes Therapieansprechen auf einen Zyklus Induktionschemotherapie mit Größenregredienz ≥ 30 % durch klinische (endoskopische) Untersuchung sowie CT-basierte Volumetrie gesichert werden kann [9].…”

Section: Chirurgie Strahlentherapie Und Medikamentöse Tumortherapieunclassified

Aktuelle Therapiekonzepte bei malignen Kopf-Hals-Tumoren

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et al. 2017

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Induction chemotherapy followed by radiotherapy for larynx preservation in advanced laryngeal and hypopharyngeal cancer: Outcome prediction after one cycle induction chemotherapy by a score based on clinical evaluation, computed tomography-based volumetry and 18F-FDG-PET/CT

Cited by 36 publications

References 25 publications

Development of a Human Leukocyte Antigen Score to Predict Progression-Free Survival in Head and Neck Squamous Cell Carcinoma Patients

Development of a Human Leukocyte Antigen Score to Predict Progression-Free Survival in Head and Neck Squamous Cell Carcinoma Patients

Meta‑analysis of diffusion‑weighted imaging for predicting locoregional failure of chemoradiotherapy in patients with head and neck squamous cell carcinoma

Aktuelle Therapiekonzepte bei malignen Kopf-Hals-Tumoren

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