Classification of three prognostically different groups of head and neck cancer patients based on their metabolic response to induction chemotherapy (IC-1)

Semrau S, Schmidt D, Hecht M, Haderlein M, Kitzsteiner C, Müller S, Traxdorf M, Agaimy A, Iro H, Kuwert T, Fietkau R (2020)

Publication Type: Journal article

Publication year: 2020

Journal

Oral Oncology Elsevier

Book Volume: 100

Article Number: 104479

DOI: 10.1016/j.oraloncology.2019.104479

Abstract

Objectives: There exist no uniform decision criteria for conservative organ preservation treatments in head and neck cancer patients. Even with ¹⁸F-FDG-PET/CT after induction chemotherapy patient selection is challenging. This study correlated metabolic tumor response with treatment types and recurrence patterns. Materials and methods: Decrease in SUVmax in ¹⁸F-FDG-PET/CT was measured 21–28 days after IC-1 in 102 patients and correlated to cancer-specific endpoints. Results: Residual SUVmax (resSUVmax) values were uniformly distributed across five cut-off levels (0–0.2 vs. >0.2–0.4 vs. >0.4–0.6 vs. >0.6–0.8 vs. >0.8) containing 20%, 25% 25%, 15% and 15% of patients. Patients were stratified into three response categories according to residual SUVmax (Group A: 0–0.4 = high response Group B: >0.4–0.8 = moderate response, Group C > 0.8 = non-response), 5-year local control rates were 90.5% (Group A) vs. 78.9% (Group B; univariate p = 0.07, multivariate: HR: 3.6, p = 0.03) vs. 49.4% (Group C vs. B; univariate p = 0.04, multivariate: HR 5.5, p < 0.01). After IC-1, Group A received chemoradiotherapy (CRT) only. Group B received surgery plus either (chemo)radiotherapy (B_S + RT/CRT) or chemoradiotherapy (B_CRT), yielding local control rates of 100% and 74.2% (p = 0.11). Group C received surgery plus CRT or CRT alone; both achieved equally poor local control (p = 0.71). Group C had significantly worse distant metastasis-free survival and overall survival than Groups A and B (p < 0.05). Conclusion: Metabolic response after IC-1 differentiates HNC patients into three subgroups predicting local tumor control. Non-response was associated with a poor outcome.

Authors with CRIS profile

Sabine Semrau Medizinische Fakultät Daniela Schmidt Medizinische Fakultät Markus Hecht Department of Radiation Oncology Marlen Haderlein Department of Radiation Oncology Maximilian Traxdorf Medizinische Fakultät Abbas Agaimy Lehrstuhl für Allgemeine Pathologie und Pathologische Anatomie Heinrich Iro Lehrstuhl für Hals-, Nasen- und Ohrenheilkunde Torsten Kuwert Lehrstuhl für Klinische Nuklearmedizin Rainer Fietkau Lehrstuhl für Strahlentherapie

How to cite

APA:

Semrau, S., Schmidt, D., Hecht, M., Haderlein, M., Kitzsteiner, C., Müller, S.,... Fietkau, R. (2020). Classification of three prognostically different groups of head and neck cancer patients based on their metabolic response to induction chemotherapy (IC-1). Oral Oncology, 100. https://doi.org/10.1016/j.oraloncology.2019.104479

MLA:

Semrau, Sabine, et al. "Classification of three prognostically different groups of head and neck cancer patients based on their metabolic response to induction chemotherapy (IC-1)." Oral Oncology 100 (2020).

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