Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2026
Tumor volume reduction during adaptive radiotherapy is a strong prognostic factor for oropharyngeal cancer: A retrospective multicenter study.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Park Seung Gyu, Yang Eunyeong, Nam Heerim, Kim Tae Gyu, Oh Dongryul, Yang Kyungmi, Ahn Yong Chan
Аннотация
PURPOSE: This study aimed to evaluate the prognostic significance of tumor volume reduction rate (TVRR) measured during mid-treatment adaptive radiation therapy (RT) for predicting survival outcomes in patients with oropharyngeal squamous cell carcinoma (OPSCC).
METHODS: This study analyzed 271 patients with OPSCC who received definitive RT, with or without concurrent systemic therapy at four institutions between 2008 and 2022. Patients underwent both pre-RT and mid-RT computed tomography simulation for adaptive re-planning. TVRR was calculated as the proportional reduction in gross tumor volume from pre-RT to mid-RT scans. A 40% threshold was applied in subsequent analyses.
RESULTS: With a median follow-up of 53 months, the 5-year overall survival (OS) and progression-free survival (PFS) were 85.4% and 74.8%. Patients with TVRR > 40% achieved superior 5-year OS (90.9% vs. 77.9%, p = 0.003) and PFS (79.0% vs. 68.5%, p = 0.039) compared with those with TVRR ≤ 40%. On multivariate analysis, TVRR > 40% was independently associated with improved OS (HR = 0.432, 95% CI: 0.221-0.846, p = 0.014). Subgroup analysis showed prognostic value of TVRR primarily in HPV-positive patients.
CONCLUSION: TVRR may serve as a useful prognostic indicator in patients with OPSCC treated with definitive RT and could help stratify patients by risk for treatment de-intensification or intensification. While prospective validation is still needed, TVRR has strong potential to enhance personalized RT and improve the treatment outcomes in patients with OPSCC.
METHODS: This study analyzed 271 patients with OPSCC who received definitive RT, with or without concurrent systemic therapy at four institutions between 2008 and 2022. Patients underwent both pre-RT and mid-RT computed tomography simulation for adaptive re-planning. TVRR was calculated as the proportional reduction in gross tumor volume from pre-RT to mid-RT scans. A 40% threshold was applied in subsequent analyses.
RESULTS: With a median follow-up of 53 months, the 5-year overall survival (OS) and progression-free survival (PFS) were 85.4% and 74.8%. Patients with TVRR > 40% achieved superior 5-year OS (90.9% vs. 77.9%, p = 0.003) and PFS (79.0% vs. 68.5%, p = 0.039) compared with those with TVRR ≤ 40%. On multivariate analysis, TVRR > 40% was independently associated with improved OS (HR = 0.432, 95% CI: 0.221-0.846, p = 0.014). Subgroup analysis showed prognostic value of TVRR primarily in HPV-positive patients.
CONCLUSION: TVRR may serve as a useful prognostic indicator in patients with OPSCC treated with definitive RT and could help stratify patients by risk for treatment de-intensification or intensification. While prospective validation is still needed, TVRR has strong potential to enhance personalized RT and improve the treatment outcomes in patients with OPSCC.