Response Evaluation in Head and Neck Oncology: Definition and Prediction

ORL J Otorhinolaryngol Relat Spec. 2017;79(1-2):14-23. doi: 10.1159/000455726. Epub 2017 Feb 24.

Abstract

Curative treatment of head and neck squamous cell carcinoma includes surgery and/or (chemo)radiation, whereas in the palliative setting, chemotherapy and/or immunotherapy represent(s) the standard approach. With regard to quality control, methods for determining treatment response are sorely needed. For surgical therapy, histopathology is the standard quality control. Established criteria for high-risk patients include resection margins of the primary tumor and extracapsular extension of lymph node metastases. After definitive chemoradiation, treatment response is generally evaluated by tomographic imaging combined with endoscopy including re-biopsy of the tumor region. Single-cycle induction chemotherapy may be used to determine the radiosensitivity of tumors, helping to define surgical and nonsurgical treatment options. Innovative approaches with implications for prognosis include the analysis of immune infiltrates, liquid biopsy, molecular characterization (proteomics, genomics), molecular and functional imaging (PET-CT, PET-MRI), as well as advanced imaging data analysis (radio[geno]mics/texture analysis). Human papilloma virus, as a prognostically relevant parameter, is currently being investigated for de-escalation strategies. With regard to the extended personalization of oncologic therapy, markers predicting treatment response are desirable and seem to be important, also from a socioeconomic perspective.

Publication types

  • Review

MeSH terms

  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy*
  • Chemoradiotherapy / methods*
  • Combined Modality Therapy
  • Disease-Free Survival
  • Evidence-Based Medicine
  • Female
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Lymph Nodes / parasitology*
  • Male
  • Medical Oncology / methods*
  • Neck Dissection / methods
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Predictive Value of Tests
  • Prognosis
  • Randomized Controlled Trials as Topic
  • Risk Assessment
  • Squamous Cell Carcinoma of Head and Neck
  • Survival Analysis
  • Treatment Outcome