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Volumetric staging in oropharyngeal cancer patients treated with definitive IMRT
Gabriela Studer1, Christoph Glanzmann
1Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland. gabriela.studer@usz.ch
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 33/27 months (3-113). Three volumetric cut-offs were used (resulting in 4 GTV subgroups: 1-15 cc (14%), 16-70 cc (62%), 71-130 cc (20%), >130 cc (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.
