Early diagnosis of radiotherapy failure for patients with head and neck cancer: the role of biochemical markers

Abstract

CYFRA 21-1 assessed at the end of RT or ChT seems to be a prognostic marker for tumor response. A high concentration of CYFRA 21-1 after treatment increases the risk of death. CYFRA 21-1 might be suggested in the monitoring of carcinomas of HNC.

Diagnostic accuracy and prognostic applications of CYFRA 21-1 in head and neck cancer: A systematic review and meta-analysis

“…As shown in Fig 1, 207 studies were retrieved initially for systematic review, of which 187 were excluded because they were repeated or did not the inclusion criteria after reviewing the title and the abstract. Finally, 20 studies published between 1998 to 2018 that met our criteria were included after reading the full text[28–47]. The main characteristics of the 20 included studies for diagnostic analysis and prognostic analyses are listed in Table 1 and Table 2, respectively.…”

Circulating HPV16 DNA may complement imaging assessment of early treatment efficacy in patients with HPV-positive oropharyngeal cancer

“…sites failed to demonstrate residual tumor and in all further18 F-FDG PET-CT scans demonstrated complete resolution of disease. Nodal failure was presented in one patient with continuously elevated HPV16 DNA with increased 18 F-FDG uptake[25].…”

“…Due to this, new markers are sought to support decisions about salvage surgery in this population of patients. Despite some promising data [18], no reliable serum tumor markers are currently available in clinical practice to indicate those patients with residual disease [3]. Due to HNC biological diversity, the identification of a molecular signature that fits all tumors universally is precluded, but HPV-related HNC may be the exception.…”

“…Radiological response of treatment in about 12th week (median 12, range 10-16 week) was assessed by 18 F-FDG PET-CT, CT or MRI. Complete radiological response (CRR) was defined as disappearance of all signs of cancer in imaging in response to treatment in the 12th week.…”

“…In the third patient lymph node dissection was successful, cfHPV16 DNA was not detected latter on during follow-up and no signs of cancer was observed (patient #22, Table 2). Another patient with partial cfHPV16 DNA remission from the IRR group demonstrated increased 18 F-FDG uptake in the liver, with no uptake at the primary site or cervical lymph nodes (patient: #10, Table 2). Core biopsy of the liver tumor confirmed metastatic p16 positive squamous cell carcinoma in this patient.…”