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Rigshospitalet - en del af Københavns Universitetshospital
Udgivet

A failure-type specific risk prediction tool for selection of head-and-neck cancer patients for experimental treatments

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Intratumor heterogeneity of PD-L1 expression in head and neck squamous cell carcinoma

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Feasibility of multi-parametric PET and MRI for prediction of tumour recurrence in patients with glioblastoma

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. On the relation between improved loco-regional control and disease-free survival in head-and-neck cancer

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Very Early Response Evaluation by PET/MR in Patients with Lung Cancer-Timing and Feasibility

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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OBJECTIVES: The objective of this work was to develop a tool for decision support, providing simultaneous predictions of the risk of loco-regional failure (LRF) and distant metastasis (DM) after definitive treatment for head-and-neck squamous cell carcinoma (HNSCC).

MATERIALS AND METHODS: Retrospective data for 560HNSCC patients were used to generate a multi-endpoint model, combining three cause-specific Cox models (LRF, DM and death with no evidence of disease (death NED)). The model was used to generate risk profiles of patients eligible for/included in a de-intensification study (RTOG 1016) and a dose escalation study (CONTRAST), respectively, to illustrate model predictions versus classic inclusion/exclusion criteria for clinical trials. The model is published as an on-line interactive tool (https://katrin.shinyapps.io/HNSCCmodel/).

RESULTS: The final model included pre-selected clinical variables (tumor subsite, T stage, N stage, smoking status, age and performance status) and one additional variable (tumor volume). The treatment failure discrimination ability of the developed model was superior of that of UICC staging, 8(th) edition (AUCLRF=72.7% vs 64.2%, p<0.001 and AUCDM=70.7% vs 58.8%, p<0.001). Using the model for trial inclusion simulation, it was found that 14% of patients eligible for the de-intensification study had>20% risk of tumor relapse. Conversely, 9 of the 15 dose escalation trial participants had LRF risks<20%.

CONCLUSION: A multi-endpoint model was generated and published as an on-line interactive tool. Its potential in decision support was illustrated by generating risk profiles for patients eligible for/included in clinical trials for HNSCC.

OriginalsprogEngelsk
TidsskriftOral Oncology
Vol/bind74
Sider (fra-til)77-82
Antal sider6
ISSN1368-8375
DOI
StatusUdgivet - nov. 2017

ID: 52024805