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A prognostic volumetric threshold of gross tumor volume in head and neck cancer patients treated with radiotherapy.

Publication ,  Journal Article
Romesser, PB; Qureshi, MM; Subramaniam, RM; Sakai, O; Jalisi, S; Truong, MT
Published in: Am J Clin Oncol
April 2014

OBJECTIVES: To determine the prognostic utility of a volumetric threshold for gross tumor volume (GTV) of the primary and nodal disease when accounting for the TNM classification in head and neck cancer (HNC) patients treated with definitive radiotherapy (RT). MATERIALS AND METHODS: From 2004 to 2011, 79 HNC patients were treated to a median dose of 70 Gy, using intensity-modulated RT in 78.5% and 3-dimensional conformal RT in 21.5% with 83.5% receiving concurrent chemotherapy. Primary (GTV-P) and nodal (GTV-N) GTVs were derived from computed tomography (CT)-based contours for RT planning, of which 89.7% were aided by positron emission tomography-computed tomography. Local (LC), nodal (NC), distant (DC) control, and overall survival (OS) were assessed using the Kaplan-Meier product-limit method. RESULTS: With a median follow-up of 27.1 months GTV-P, threshold of <32.9 mL (mean value) compared with ≥32.9 mL, correlated with improved 2-year LC (96.2% vs. 63.9%, P<0.0001), NC (100% vs. 69.2%, P<0.0001), DC (87.9% vs. 64.2%, P=0.001), and OS (88.4% vs. 58.6%, P=0.001). GTV-P demonstrated its prognostic utility in multivariate analyses when adjusted for tumor category, cancer site, and chemotherapy regimen. Nodal GTV (mean, 34.0 mL) was not predictive of nodal control and survival. CONCLUSIONS: A volumetric threshold of the primary tumor may be used as an independent prognostic factor in patients with HNC undergoing definitive RT.

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Published In

Am J Clin Oncol

DOI

EISSN

1537-453X

Publication Date

April 2014

Volume

37

Issue

2

Start / End Page

154 / 161

Location

United States

Related Subject Headings

  • Tumor Burden
  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Radiotherapy, Intensity-Modulated
  • Radiotherapy, Conformal
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy Dosage
  • ROC Curve
  • Prognosis
  • Predictive Value of Tests
 

Citation

APA
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ICMJE
MLA
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Romesser, P. B., Qureshi, M. M., Subramaniam, R. M., Sakai, O., Jalisi, S., & Truong, M. T. (2014). A prognostic volumetric threshold of gross tumor volume in head and neck cancer patients treated with radiotherapy. Am J Clin Oncol, 37(2), 154–161. https://doi.org/10.1097/COC.0b013e31826e04d6
Romesser, Paul B., Muhammad M. Qureshi, Rathan M. Subramaniam, Osamu Sakai, Scharukh Jalisi, and Minh T. Truong. “A prognostic volumetric threshold of gross tumor volume in head and neck cancer patients treated with radiotherapy.Am J Clin Oncol 37, no. 2 (April 2014): 154–61. https://doi.org/10.1097/COC.0b013e31826e04d6.
Romesser PB, Qureshi MM, Subramaniam RM, Sakai O, Jalisi S, Truong MT. A prognostic volumetric threshold of gross tumor volume in head and neck cancer patients treated with radiotherapy. Am J Clin Oncol. 2014 Apr;37(2):154–61.
Romesser, Paul B., et al. “A prognostic volumetric threshold of gross tumor volume in head and neck cancer patients treated with radiotherapy.Am J Clin Oncol, vol. 37, no. 2, Apr. 2014, pp. 154–61. Pubmed, doi:10.1097/COC.0b013e31826e04d6.
Romesser PB, Qureshi MM, Subramaniam RM, Sakai O, Jalisi S, Truong MT. A prognostic volumetric threshold of gross tumor volume in head and neck cancer patients treated with radiotherapy. Am J Clin Oncol. 2014 Apr;37(2):154–161.

Published In

Am J Clin Oncol

DOI

EISSN

1537-453X

Publication Date

April 2014

Volume

37

Issue

2

Start / End Page

154 / 161

Location

United States

Related Subject Headings

  • Tumor Burden
  • Treatment Outcome
  • Tomography, X-Ray Computed
  • Radiotherapy, Intensity-Modulated
  • Radiotherapy, Conformal
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy Dosage
  • ROC Curve
  • Prognosis
  • Predictive Value of Tests