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Volumetric staging in oropharyngeal cancer patients treated with definitive IMRT


Studer, Gabriela; Glanzmann, Christoph (2013). Volumetric staging in oropharyngeal cancer patients treated with definitive IMRT. Oral Oncology, 49(3):269-276.

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). PATIENTS: Between 04/2002 and 12/2011, 277 consecutive OC patients underwent definitive IMRT. Mean/median follow-up was 33/27months (3-113). Three volumetric cut-offs were used (resulting in 4 GTV subgroups: 1-15cc (14%), 16-70cc (62%), 71-130cc (20%), >130cc (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). CONCLUSION: 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.

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). PATIENTS: Between 04/2002 and 12/2011, 277 consecutive OC patients underwent definitive IMRT. Mean/median follow-up was 33/27months (3-113). Three volumetric cut-offs were used (resulting in 4 GTV subgroups: 1-15cc (14%), 16-70cc (62%), 71-130cc (20%), >130cc (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). CONCLUSION: 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.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Radiation Oncology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2013
Deposited On:25 Mar 2013 08:03
Last Modified:24 Sep 2019 19:09
Publisher:Pergamon
ISSN:1368-8375
OA Status:Closed
Publisher DOI:https://doi.org/10.1016/j.oraloncology.2012.09.014
PubMed ID:23089460

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