Oligometastatic head and neck cancer: Which patients benefit from radical local treatment of all tumour sites?

Weissmann T, Höfler D, Hecht M, Semrau S, Haderlein M, Filimonova I, Frey B, Bert C, Lettmaier S, Mantsopoulos K, Iro H, Fietkau R, Putz F (2021)

Publication Type: Journal article

Publication year: 2021

Journal

Radiation Oncology BioMed Central

Book Volume: 16

Article Number: 62

Journal Issue: 1

DOI: 10.1186/s13014-021-01790-w

Abstract

Background: There is a large lack of evidence for optimal treatment in oligometastatic head and neck cancer and it is especially unclear which patients benefit from radical local treatment of all tumour sites. Methods: 40 patients with newly diagnosed oligometastatic head and neck cancer received radical local treatment of all tumour sites from 14.02.2008 to 24.08.2018. Primary endpoint was overall survival. Time to occurrence of new distant metastases and local control were evaluated as secondary endpoints as well as prognostic factors in univariate und multivariate Cox’s regression analysis. To investigate the impact of total tumour volume on survival, all tumour sites were segmented on baseline imaging. Results: Radical local treatment included radiotherapy in 90% of patients, surgery in 25% and radiofrequency ablation in 3%. Median overall survival from first diagnosis of oligometastatic disease was 23.0 months, 2-year survival was 48%, 3-year survival was 37%, 4-year survival was 24% and 5-year survival was 16%. Median time to occurrence of new distant metastases was 11.6 months with freedom from new metastases showing a tail pattern after 3 years of follow-up (22% at 3, 4- and 5-years post-treatment). In multivariate analysis, better ECOG status, absence of bone and brain metastases and lower total tumour volume were significantly associated with improved survival, whereas the number of metastases and involved organ sites was not. Conclusions: Radical local treatment in oligometastatic head and neck cancer shows promising outcomes and needs to be further pursued. Patients with good performance status, absence of brain and bone metastases and low total tumour volume were identified as optimal candidates for radical local treatment in oligometastatic head and neck cancer and should be considered for selection in future prospective trials.

Authors with CRIS profile

Daniel Höfler Department of Radiation Oncology Markus Hecht Department of Radiation Oncology Sabine Semrau Medizinische Fakultät Marlen Haderlein Department of Radiation Oncology Irina Filimonova Lehrstuhl für Strahlentherapie Benjamin Frey Department of Radiation Oncology Christoph Bert Professur für Med. Strahlenphysik Konstantinos Mantsopoulos Department of Otorhinolaryngology – Head and Neck Surgery Heinrich Iro Lehrstuhl für Hals-, Nasen- und Ohrenheilkunde Rainer Fietkau Lehrstuhl für Strahlentherapie Florian Putz Department of Radiation Oncology

How to cite

APA:

Weissmann, T., Höfler, D., Hecht, M., Semrau, S., Haderlein, M., Filimonova, I.,... Putz, F. (2021). Oligometastatic head and neck cancer: Which patients benefit from radical local treatment of all tumour sites? Radiation Oncology, 16(1). https://dx.doi.org/10.1186/s13014-021-01790-w

MLA:

Weissmann, Thomas, et al. "Oligometastatic head and neck cancer: Which patients benefit from radical local treatment of all tumour sites?" Radiation Oncology 16.1 (2021).

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