Tumor Volume Predicts Outcome for Advanced Head and Neck Cancer Treated With Targeted Chemoradiotherapy

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<jats:title>Abstract</jats:title><jats:p><jats:bold>Objectives/Hypothesis</jats:bold> Just as tumor volume is a prognostic indicator for local disease control among patients with head and neck cancer of intermediate size treated with radiation therapy, we hypothesized a similar association for patients with advanced disease treated with chemoradiation therapy.</jats:p><jats:p><jats:bold>Study Design</jats:bold> Retrospective analysis of primary and nodal tumor volume was correlated with prospectively collected treatment outcome measures.</jats:p><jats:p><jats:bold>Methods</jats:bold> Sixty‐four patients with stage III‐IV disease who were treated with targeted intra‐arterial chemotherapy and radiation therapy (RADPLAT) were studied. Tumor volume was correlated with local disease control and survival.</jats:p><jats:p><jats:bold>Results</jats:bold> Primary tumor volume correlated with local disease control and survival. The greatest risk for local failure was found among patients with primary tumor volume greater than 19.6 cc (93.8% vs. 57% [<jats:italic>P</jats:italic> = .001]). A nominal logistic regression analysis demonstrated primary tumor volume as being the only significant parameter related to local failure. Survival was only 14.1% among patients with primary tumor volume greater than 19.6 cc compared with 41.5% for patients with volumes less than 19.6 cc (<jats:italic>P</jats:italic> = .0018). A proportional hazard model indicated that the most significant and independent parameters associated with survival were primary tumor volume (<jats:italic>P</jats:italic> = .0007) and the site of the tumor (<jats:italic>P</jats:italic> = .05).</jats:p><jats:p><jats:bold>Conclusion</jats:bold> Tumor volume is the most important factor predictive of treatment outcome among patients with advanced head and neck cancer and should be used to stratify favorable versus unfavorable patient subsets.</jats:p>

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