Patterns of local-regional recurrence after conformal and intensity-modulated radiotherapy for head and neck cancer

Johansen, Safora; Norman, Mathilde H.; Dale, Einar; Amdal, Cecilie Delphin; Furre, Torbjørn; Malinen, Eirik; Evensen, Jan F.

doi:10.1186/s13014-017-0829-5

Cited by 22 publications

(12 citation statements)

References 11 publications

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“…Although half of our patients who had an in-field recurrence had received definitive CRT as a primary treatment, no significant relation was observed between primary treatment modality and recurrence class. This result is similar to the findings of Johansen et al [16] who did not include information about p16 status in their findings but based on tumor sites included mostly p16 negative patients.…”

Section: Treatmentsupporting

confidence: 91%

Recurrence of head and neck squamous cell carcinoma in relation to high-risk treatment volume

Nissi

Suilamo

Kytö

et al. 2021

Clinical and Translational Radiation Oncology

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Background: Locoregional recurrence remains a major cause of failure in head and neck squamous cell carcinoma (HNSCC). Human papilloma virus (HPV)-associated HNSCCs generally have a good prognosis but may recur even after standard photon radiotherapy (RT). Another incentive in observing patterns of recurrence is increased use of highly conformal techniques such as proton therapy. We therefore studied geographic distribution of recurrent tumors in relation to the high-risk treatment volume in a cohort of patients with HNSCC receiving combined modality therapy. Methods: Medical records of 508 patients diagnosed with HNSCC in 2010-2015 were reviewed. We identified a subgroup that had local and/or regional recurrence at hybrid positron emission tomography (PET)/computed tomography (CT) and/or magnetic resonance imaging (MRI). We adapted p16 as a surrogate marker for HPV-positivity and only patients with known p16 status were eligible for a detailed analysis where recurrent tumor was copied on the planning CT and the dose received by the recurrent tumor volume was determined using dose-volume histograms. Results: Twenty-five patients who had received either cisplatin (n = 23) or cetuximab-enhanced (n = 2) RT were identified. 31 locoregional recurrent tumors were detected among 18 p16 negative and 7 p16 positive patients. Of recurrent tumors 14 (45%) were classified as in-field, 5 (16%) as marginal miss, and 12 (39%) as true miss. p16 positive patients had 4 in-field, 2 marginal, and 1 true miss. By contrast, p16 negative patients had 10 in-field, 3 marginal, and 11 true miss recurrences. Conclusions: Both p16 positive and negative HNSCC recur in high-risk treatment volume despite the common view of high radiosensitivity of the former. Biomarkers predicting radioresistance should be characterized in p16 positive tumors before widely embarking on de-escalated CRT protocols. Another concern is how to decrease the number of true or marginal misses in p16 negative cases despite multimodality imaging-based target delineation.

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Section: Treatmentsupporting

confidence: 91%

Recurrence of head and neck squamous cell carcinoma in relation to high-risk treatment volume

Nissi

Suilamo

Kytö

et al. 2021

Clinical and Translational Radiation Oncology

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“…Prior works have documented the different failure patterns for HNC patients. Oksuz et al (8) and Johansen et al (7), for example, analyzed the recurrence patterns among HNC patients treated with radical (chemo-) radiotherapy. They reported that “in field” failures were the majority of recurrence.…”

Section: Discussionmentioning

confidence: 99%

Use of Radiomics Combined With Machine Learning Method in the Recurrence Patterns After Intensity-Modulated Radiotherapy for Nasopharyngeal Carcinoma: A Preliminary Study

Wang

Hou

et al. 2018

Front. Oncol.

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Objective: To analyze the recurrence patterns and reasons in patients with nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy (IMRT) and to investigate the feasibility of radiomics for analysis of radioresistance.Methods: We analyzed 306 NPC patients treated with IMRT from Jul-2009 to Aug-2016, 20 of whom developed with recurrence. For the NPCs with recurrence, CT, MR, or PET/CT images of recurrent disease were registered with the primary planning CT for dosimetry analysis. The recurrences were defined as in-field, marginal or out-of-field, according to dose-volume histogram (DVH) of the recurrence volume. To explore the predictive power of radiomics for NPCs with in-field recurrences (NPC-IFR), 16 NPCs with non-progression disease (NPC-NPD) were used for comparison. For these NPC-IFRs and NPC-NPDs, 1117 radiomic features were quantified from the tumor region using pre-treatment spectral attenuated inversion-recovery T2-weighted (SPAIR T2W) magnetic resonance imaging (MRI). Intraclass correlation coefficients (ICC) and Pearson correlation coefficient (PCC) was calculated to identify influential feature subset. Kruskal-Wallis test and receiver operating characteristic (ROC) analysis were employed to assess the capability of each feature on NPC-IFR prediction. Principal component analysis (PCA) was performed for feature reduction. Artificial neural network (ANN), k-nearest neighbor (KNN), and support vector machine (SVM) models were trained and validated by using stratified 10-fold cross validation.Results: The median follow up was 26.5 (range 8–65) months. 9/20 (45%) occurred in the primary tumor, 8/20 (40%) occurred in regional lymph nodes, and 3/20 (15%) patients developed a primary and regional failure. Dosimetric and target volume analysis of the recurrence indicated that there were 18 in-field, and 1 marginal as well as 1 out-of-field recurrence. With pre-therapeutic SPAIR T2W MRI images available, 11 NPC-IFRs (11 of 18 NPC-IFRs who had available pre-therapeutic MRI) and 16 NPC-NPDs were subsequently employed for radiomic analysis. Results showed that NPC-IFRs vs. NPC-NPDs could be differentiated by 8 features (AUCs: 0.727–0.835). The classification models showed potential in prediction of NPC-IFR with higher accuracies (ANN: 0.812, KNN: 0.775, SVM: 0.732).Conclusion: In-field and high-dose region relapse were the main recurrence patterns which may be due to the radioresistance. After integration in the clinical workflow, radiomic analysis can be served as imaging biomarkers to facilitate early salvage for NPC patients who are at risk of in-field recurrence.

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“…Radiotherapy is a particular therapeutic method for haematological neoplasms (Johansen et al, 2017). A combination of melatonin with 4 Gy irradiation induced apoptosis of Jurkat leukaemia cells in C57BL/6 mice, concomitant with prolonged lifetime of the leukaemic animals.…”

Section: Figurementioning

confidence: 99%

Melatonin: does it have utility in the treatment of haematological neoplasms?

Tian

Yang

Jiang

et al. 2017

British J Pharmacology

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Melatonin, discovered in 1958 in the bovine pineal tissue, is an indoleamine that modulates circadian rhythms and has a wide variety of other functions. Haematological neoplasms are the leading cause of death in children and adolescents throughout the world. Research has demonstrated that melatonin is a low-toxicity protective molecule against experimental haematological neoplasms, but the mechanisms remain poorly defined. Here, we provide an introduction to haematological neoplasms and melatonin, especially as they relate to the actions of melatonin on haematological carcinogenesis. Secondly, we summarize what is known about the mechanisms of action of melatonin in the haematological system, including its pro-apoptotic, pro-oxidative, anti-proliferative and immunomodulatory actions. Thirdly, we discuss the advantages of melatonin in combination with other drugs against haematological malignancy, as well as its other benefits on the haematological system. Finally, we summarize the findings that are contrary to the suppressive effects of melatonin on cancers of haematological origin. We hope that this information will be helpful in the design of studies related to the therapeutic efficacy of melatonin in haematological neoplasms.

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Patterns of local-regional recurrence after conformal and intensity-modulated radiotherapy for head and neck cancer

Cited by 22 publications

References 11 publications

Recurrence of head and neck squamous cell carcinoma in relation to high-risk treatment volume

Recurrence of head and neck squamous cell carcinoma in relation to high-risk treatment volume

Use of Radiomics Combined With Machine Learning Method in the Recurrence Patterns After Intensity-Modulated Radiotherapy for Nasopharyngeal Carcinoma: A Preliminary Study

Melatonin: does it have utility in the treatment of haematological neoplasms?

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