Tumor volume as prognostic factor in chemoradiation for advanced head and neck cancer

Head Neck. 2011 Mar;33(3):375-82. doi: 10.1002/hed.21459.


Background: Tumor volume is an important predictor of outcome in radiotherapy alone. Its significance in concomitant chemoradiation (CCRT) is much less clear. We analyzed the prognostic value of primary tumor volume for advanced head and neck squamous cell carcinoma (HNSCC) treated with CCRT.

Methods: Three hundred sixty patients treated with definitive CCRT for advanced HNSCC were selected. The pretreatment MRI or CT scan was used to calculate the primary tumor volume. Median follow-up was 19.8 months.

Results: The average primary tumor volume was 37.0 cm³ (range, 2.1-182.7 cm³; median, 28.7 cm³). Multivariate analysis showed a significant effect of tumor volume on local control. The hazard ratio for a local recurrence increased by 14% per 10 cm³ volume increase (95% CI, 8% to 21%). There was no significant independent effect of T and N status on local control.

Conclusion: For advanced HNSCC, tumor volume is more powerful for predicting outcome after CCRT than TNM status.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology*
  • Carcinoma, Squamous Cell / therapy*
  • Cohort Studies
  • Combined Modality Therapy
  • Disease-Free Survival
  • Female
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / pathology*
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Kaplan-Meier Estimate
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Quality of Life
  • Radiotherapy, High-Energy / methods
  • Retrospective Studies
  • Risk Assessment
  • Survival Rate
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome
  • Tumor Burden / drug effects*
  • Tumor Burden / radiation effects*