Pretreatment oxygenation predicts radiation response in advanced squamous cell carcinoma of the head and neck
Abstract
Background and purpose Hypoxic tumor cells are known to be relatively radioresistant. The aim of the study was to correlate oxygenation status and radiation response in advanced squamous cell carcinomas of head and neck.Methods and patients Pretreatment oxygenation status was measured in 34 lymph nodes and one primary tumor neck using oxygen electrodes. The primary oxygenation endpoint was the fraction of pO2 values less than 2.5 mmHg. Patients received standardized, conventional, external radiotherapy 66-68 Gy in 33-34 fractions.Results Sixteen patients had loco-regional failure. Among these 16 patients the median of the fraction of pO2 values less than 2.5 mmHg was 22% (range 0-95%) as compared to 6% (range 0-51%) among patients with loco-regional tumor control. When separating all 35 patients by the median of the fraction of pO2 values less than 2.5 mmHg and comparing the 2 years actuarial tumor control probability using Kaplan-Meier estimates, the most hypoxic subgroup had significantly lower loco-regional tumor control (P = 0.013, Logrank test). By univariate regression analysis the fraction of pO2 values less than 2.5 mmHg was found to be significant as continuous variable (P = 0.010). Finally, by Cox multiple regression analysis the fraction of pO2 values less than 2.5 mmHg was found to be the strongest independent variable in predicting radiation response when using tumor control in the site of pO2 assessment as treatment endpoint (P = 0.018).Conclusion These results suggest that pretreatment tumor oxygenation status is predictive of radiation response, when using the fraction of pO2 values less than 2.5 mmHg as endpoint.
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There is increasing evidence that tumors with more hypoxic cells are poorly responsive to radiation therapy.
“There is increasing evidence that tumors with more hypoxic cells are poorly responsive to radiation therapy.”
From Hypoxia signaling in cancer: Implications for therapeutic interventions (2023) · cites this paper as [335]
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- Authors
- Nordsmark, M., Overgaard, M., & Overgaard, J.
- Affiliations
- Danish Cancer Society (DK)
- Aarhus University Hospital (DK)
- Corresponding author
- Nordsmark, Marianne
- Venue
- Radiotherapy and Oncology
- Publisher
- Elsevier BV
- Published
- 1996-01
- Volume
- 41
- Issue
- 1
- Pages
- 31-39
- ISSN
- 0167-8140 (ISSN-L)
- OpenAlex
- W2087604644
- Cited by
- 942
- References
- 34
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 6 · 2023: 5 · 2022: 12 · 2021: 20 · 2020: 19 · 2019: 15 · 2018: 19 · 2017: 20 · 2016: 34 · 2015: 25 · 2014: 28 · 2013: 20 · 2012: 25
- FWCI
- 57.63
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Radiotherapy and Oncology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Otorhinolaryngology › Head and Neck Cancer Studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Hypoxia, and Metabolism
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Radiation Therapy and Dosimetry
- Keywords
- head and neck squamous cell carcinoma, tumor hypoxia, tumor oxygenation, radiation response, oxygen electrode, predictive biomarkers, radioresistance (biology)
- MeSH terms
- Carcinoma, Squamous Cell, Female, Head and Neck Neoplasms, Humans, Male, Middle Aged, Neoplasm Recurrence, Local, Radiotherapy Dosage, Radiotherapy, High-Energy, Cell Hypoxia, Proportional Hazards Models, Case-Control Studies, Treatment Outcome, Ion-Selective Electrodes
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