Observational Study on Biomarkers in Head and Neck Cancer (HNprädBio)

Objectives:

Primary: Evaluation of local-regional recurrence- free survival after two years of patients with locally advanced head and neck cancer who received definitive or adjuvant radiochemotherapy.

Secondary: Evaluation of disease-free -survival, metastases-free and overall survival after two years, of patients with locally advanced head and neck cancer.

Outline: This is a multicenter observational study. The treatment is based on the center specific standard of care. The total dose will be between 69 and 73 Gy (definitive treatment) and 63 and 66 Gy (adjuvant treatment), the chemotherapy will be cisplatin- based.

The aim of the analysis is to validate the prognostic impact of potential biomarkers on loco-regional control. This will lead to the definition of risk groups and stratification of patients and will help to individualize radiotherapy prescription in future trials.

Inclusion criteria

Primary radiochemotherapy:

• Patients with locally advanced squamous cell carcinoma of the oral cavity, oropharynx or hypopharynx
• Stage III or IV without distant metastases
• Patient is able to participate in regular tumor follow-up care
• planned irradiation dose 69-72 Gy
• planned overall treatment time 38-54 days
• written informed consent of the patient
• general condition according to WHO 0-2
• planned simultaneous chemotherapy with cisplatin (cumulative planned total dose minimum 180 mg/m2 body surface, divided in several separately doses)

Adjuvant radiochemotherapy:

• Patients with locally advanced squamous cell carcinoma of the oral cavity, oropharynx or hypopharynx
• surgery, existence of one or more of the following risk factors for local recurrence:
• extracapsular growth of a minimum of one lymph node metastasis
• R1 resection
• pT4 tumor and more than 3 affected lymph nodes
• Patient is able to participate in regular tumor follow-up care
• planned irradiation dose 63-66 Gy
• planned overall treatment time 44-48 days
• planned simultaneous chemotherapy with cisplatin (cumulative planned total dose minimum 200 mg/m2 body surface, divided in several separately doses)
• written informed consent of the patient
• general condition according to WHO 0-2
• time since last surgery <56 days (8 weeks)

Exclusion criteria

Primary radiochemotherapy:

• distant metastasis
• contraindication against a cisplatin-based chemotherapy
• planned total irradiation dose <69 Gy and >72 Gy
• planned overall treatment time >54 days or <38 days
• Patient is incapable of giving consent
• previous radiotherapy in the head and neck area, if there is a risk for overlapping of the irradiation areas
• other tumor diseases, which currently need a treatment or probably within the next two years or which influence the prognosis of the patient
• tumor-independent diseases or conditions which reduce the survival probability of the patient to <2 years or which affect the follow-up over 2 years
• no written informed consent
• induction chemotherapy
• pregnancy or lactation

Adjuvant radiochemotherapy:

• distant metastasis
• contraindication against a cisplatin-based chemotherapy
• planned total irradiation dose < 63 Gy or > 66 Gy
• planned overall treatment time > 48 days or < 44 day
• Patient is incapable of giving consent
• previous radiotherapy in the head and neck area, if there is a risk for overlapping of the irradiation areas
• other tumor diseases, which currently need a treatment or probably within the next two years or which influence the prognosis of the patient
• tumor-independent diseases or conditions which reduce the survival probability of the patient to <2 years or which affect the follow-up over 2 years
• no written informed consent
• pregnancy or lactation