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Impact of hypoxia in head and neck cancer radiotherapy

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Grégoire, Vincent [UCL] Eriksen, Jesper

Background Radiotherapy plays an important role in the treatment of pharyngo-laryngeal and oral cavity head and neck squamous cell carcinoma (HNSCC) either as single modality, in combination with concomitant chemotherapy or epithermal growth factor inhibitor, or as adjuvant treatment after curative surgery. Various biological factors have been shown to impact on tumour response to radiotherapy, and among them tumour hypoxia. Aim This article reviews the clinical data on measurement of tumour hypoxia and summarizes the various options to counteract it, with a special emphasis on the use of hypoxic cell radiosensitizers, radiation dose escalation, and the proper selection of patients who may benefit from such therapeutic interventions. Results It has been shown that up to 25% of HNSCC express pO2 value below 2.5 mm Hg, and modification of tumour hypoxia has been demonstrated to improve loco-regional control and overall survival. In particular, the concomitant use of nimorazole, a hypoxic cell radiosensitizer, has been demonstrated in a seminal DAHANCA trial to significantly improve outcome in patients with head and neck SCC. More recently, among the patients included into this trial, a 15-gene hypoxia classifier indicated that only those patients with hypoxic tumours benefited from the combined radiotherapy and nimorazole treatment. Conclusions An ongoing trial is validating both the use of nimorazole and the gene classifier for patients treated with concomitant chemo-radiotherapy.

Document type Article de périodique (Journal article)
Access type Accès libre
Publication date 2017
Language Anglais
Journal information "Clinical and Translational Imaging" - Vol. 5, no.6, p. 497-505 (2017)
Peer reviewed yes
Publisher Springer Nature
issn 2281-5872
e-issn 2281-7565
Publication status Publié
Affiliations UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie
UCL - (SLuc) Centre du cancer
UCL - (SLuc) Service de radiothérapie oncologique
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Bibliographic reference Grégoire, Vincent ; Eriksen, Jesper. Impact of hypoxia in head and neck cancer radiotherapy. In: Clinical and Translational Imaging, Vol. 5, no.6, p. 497-505 (2017)
Permanent URL http://hdl.handle.net/2078.1/220235