Clinical radiobiologyPrognostic value of tumor oxygenation in 397 head and neck tumors after primary radiation therapy. An international multi-center study
Section snippets
Patient characteristics and inclusion criteria
The present study includes 397 patients with advanced head and neck cancer referred to the departments of Oncology, Aarhus University Hospital, DK; Radiation Oncology, University of Heidelberg, G; Institute Gustave Roussy, Villejuif, F; Radiotherapy and Radiation Oncology, Technical University, Münich, G; Radiotherapy, Martin Luther University, Halle-Wittenberg, G; Radiation Oncology, Division for Radiation Biology and Surgery, Stanford University, USA and Radiation Oncology, Duke University,
Oxygenation parameters
Distribution parameters of tumor oxygenation in the various centers are shown in Table 3. There was a substantial inter-individual heterogeneity in tumor hypoxia with an overall median tumor pO2=9 mmHg (range 0–62 mmHg), a median HP2.5 of 19% (range 0–97%) and HP5 of 38%, (range 0–100%). A statistically significant inter-institutional difference in the distribution of tumor oxygenation parameters was observed (HP2.5, P=0.02, HP5, P=0.001 and median tumor pO2, P=0.001, Kruskal–Wallis test) with
Discussion
The current study summarizes the World-wide experience with micro-electrode measurements of oxygen tension as a possible predictive assay for outcome after radiotherapy for advanced head and neck cancer. Data from seven institutions and 397 patients were analyzed using the Cox proportional hazards model. The pre-treatment tumor oxygenation status was found to be a highly significant prognostic factor for survival after radiotherapy alone or in combination with surgery, chemotherapy or a
Acknowledgements
Financial support was obtained from the Danish Cancer Society, the Research, the Development program at Mount Vernon Hospital, UK, Grants CA 67166 and DFG Ad123/1-1 and Ad123/1-2.
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