Two-year results from a Swedish study on conventional versus accelerated radiotherapy in head and neck squamous cell carcinoma – The ARTSCAN study

Zackrisson, Björn; Nilsson, Per; Kjellén, Elisabeth; Johansson, Karl-Axel; Modig, Hans; Brun, Eva; Nyman, Jan; Friesland, Signe; Reizenstein, Johan; Sjödin, Helena; Ekberg, Lars; Lödén, Britta; Mercke, Claes; Fernberg, Jan-Olof; Franzén, Lars; Ask, Anders; Persson, Essie; Wickart-Johansson, Gun; Lewin, Freddi; Wittgren, Lena; Björ, Ove; Björk‐Eriksson, Thomas

doi:10.1016/j.radonc.2010.12.010

Cited by 35 publications

(41 citation statements)

References 32 publications

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“…Patients were randomized to RT with conventional fractionation (2 Gy/day, 5 days/week for 7 weeks, total dose 68 Gy) versus accelerated fractionation (AF; 1.1 Gy+ 2 Gy/day, 5 days/week for 7 weeks, total dose 68 Gy). The 2-year results were previously published [6]. The 5-year results confirm the 2-year results with no difference in terms of OS and LRC between the two arms.…”

Section: Trials On Optimization Of Radiotherapy and Radiochemotherapysupporting

confidence: 81%

Recent innovations in head and neck oncology: a report from the ICHNO

Stoeckli

Broglie

2013

Expert Review of Anticancer Therapy

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Section: Trials On Optimization Of Radiotherapy and Radiochemotherapysupporting

confidence: 81%

Recent innovations in head and neck oncology: a report from the ICHNO

Stoeckli

Broglie

2013

Expert Review of Anticancer Therapy

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“…Competing risks were: LRF (distant metastasis or death); LF (failures not including T-site or death); DSD (death in patients cured for the glottic cancer); Laryngectomy (death); NPT (death); OS and EFS (no competing events). Risk differences (RD) were estimated using the pseudo value approach [11]. RDs were presented as the percentage point lower risk after 6 fx/w compared to 5 fx/w.…”

Section: Statistics and Endpoint Definitionsmentioning

confidence: 99%

“…Subsequent sub-analyses revealed that ACC RT improved loco-regional control regardless of HPV/p16-status [4] and also improved loco-regional control in patients with high tumor expression of the epidermal growth factor receptor and well/moderate tumor differentiation [5]. A detailed analysis of treatment related morbidity demonstrated some increase in acute, but no increase in late morbidity in the ACC RT group [6,7] Though not all find an effect of acceleration [8][9][10][11], other studies have substantiated the positive effect of moderate ACC RT in head and neck SCC [12,13], but have often not included early stage and/-or glottic tumors [14,15]. The DAHANCA 6 study is, by far, the largest study specifically investigating the effect of moderate acceleration in glottic SCC patients.…”

Section: Introductionmentioning

confidence: 99%

The DAHANCA 6 randomized trial: Effect of 6 vs 5 weekly fractions of radiotherapy in patients with glottic squamous cell carcinoma

Lyhne

Primdahl

Kristensen

et al. 2015

Radiotherapy and Oncology

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“…Advances in this field have been made with the help of vascular free flaps, however this has not improved the overall survival (Shah 2007 RT can be given in a variety of ways delivering different dosages once or twice daily. A lot of research has been focused on trying to optimize dosage plans resulting in accelerated fractionation, hyperfractionation (Horiot et al 1992;Zackrisson et al 2011), and intensitymodulating radiotherapy (Argiris et al 2008), however, the benefits of these treatments over conventional RT are still debatable (Peters 2007).…”

Section: Surgerymentioning

confidence: 99%

Understanding the Role of EGFR in the Treatment of Head and Neck Squamous Cell Carcinoma

Jedliński¹

2014

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Head and neck squamous cell carcinoma (HNSCC) originates from the epithelial lining of the upper aerodigestive tract. It accounts for over 90 % of the malignancies found in the head and neck region. 600,000 new cases of HNSCC occur each year worldwide. Apart from causing painful lesions, HNSCC directly impacts the patient’s fundamental functions such as breathing and eating and also can disrupt the patient’s senses such as smell, taste, speech and even vision. Most cases of HNSCC require a combination of different treatments such as surgery, chemotherapy (primarily cisplatin based), and radiotherapy. Treatment decisions are largely based on the size of the tumor, the involvement of local lymph nodes, and distant spread. Treatment resistance and local recurrence are significant problems and to date no form of clinical treatment sensitivity prediction is available. A majority of HNSCC tumors overexpresses the epidermal growth factor receptor (EGFR). This receptor is involved in proliferation and DNA repair and is the target of a monoclonal antibody named cetuximab that selectively binds and inhibits EGFR. It is the only targeted therapy available to HNSCC patients and reserved for late stage patients in Sweden. Numerous investigators have searched for predictive markers and we hypothesized that since HNSCC is a very heterogeneous disease a single factor would not be able to predict the treatment outcome. In paper I we explore a panel of predictive factors using a point system, called the number of negative points (NNP), in which we could combine both proteins and genetic variations in an attempt to find a set of markers that could predict the intrinsic cisplatin sensitivity (ICS). The expression level of EGFR, Hsp70, Bax, Bcl-XL, survivin, and COX-2 was determined in 39 HNSCC cell lines. Moreover, the p53, MDM2, FGFR4, XPC, XPD, XRCC1, and XRCC3 genes were analyzed for the presence of specific single nucleotide polymorphisms (SNPs). Pearson’s correlation tests showed that EGFR was the only protein that alone correlated to ICS (r=0.388, P=0.015). The strongest correlation to ICS was found when combining SNPs in XRCC3 and XPD with the expression of EGFR, Hsp70, Bax, and Bcl-2 using the NNP system (r=0.614 P≤0.001). In paper II we assess the intrinsic radiosensitivity (IR), the ICS, and the intrinsic cetuximab sensitivity (ICmabS) as well as their combinations in 25 HNSCC cell lines established from HNSCC biopsies taken at the Department of Otorhinolaryngology and Head and Neck Surgery at Linköping University Hospital. Furthermore we investigate the EGFR status (consisting of EGFR gene copy number, EGFR mRNA, EGFR protein, pEGFR), pAkt and mRNA levels of the seven known EGFR ligands. No correlation was found between the different treatment sensitivities. Cetuximab treatment response was significantly correlated to epiregulin (EREG) mRNA expression (r=-0.408, P=0.043). Cetuximab resistant cell lines tended to have low levels of pEGFR (P=0.13) while resistant cell lines had a significantly lower expression of EGFR pro...

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Two-year results from a Swedish study on conventional versus accelerated radiotherapy in head and neck squamous cell carcinoma – The ARTSCAN study

Cited by 35 publications

References 32 publications

Recent innovations in head and neck oncology: a report from the ICHNO

Recent innovations in head and neck oncology: a report from the ICHNO

The DAHANCA 6 randomized trial: Effect of 6 vs 5 weekly fractions of radiotherapy in patients with glottic squamous cell carcinoma

Understanding the Role of EGFR in the Treatment of Head and Neck Squamous Cell Carcinoma

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