Does Selective Radiation Dose Escalation and Tumor Hypoxia Status impact the locoregional Tumor Control after Radiochemotherapy of Head and Neck Tumors?

• Applicant: Dr. Steffi Pigorsch, since 4/2014
• Subject Area: Nuclear Medicine, Radiotherapy, Radiobiology
• Term: from 2009 to 2018
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 73520910

The major clinical problem and predominant cause of death after radiooncological treatment of H+N cancers are locoregional relapses. This randomized trial tests the hypothesis that dose escalated Intensity Modulated Radiotherapy (IMRT) selectively applicated to the macroscopic primary tumor and involved neck nodes which both in 80% are hypoxic improves locoregional control by at least 15% at 2 years. IMRT is combined with concurrent Cis-Platin chemotherapy. Tumor volume which correlates with number of malignant cells as well as tumor hypoxia are important biological parameters which increase radioresistance, failure of local control and tumor progression. Basing on data of experimental and clinical radiation oncology we consider hypoxia as a useful parameter for pretherapeutic stratification in future randomized radio-chemotherapy trials. In addition, hypoxia imaging by PET can also be used for testing the significance of selective dose escalation on hypoxic tumor sub-volumes ("Dose Painting"). As a prerequisite for such innovative studies addressing hypoxia the translational part investigates the following key issues: correlation between the size of total tumor volume (primary, lymph nodes) and hypoxic sub-volume, the spatial shift of the hypoxic sub-volume before start of treatment and the correlation between locoregional control and hypoxia.

• DFG Programme: Clinical Trials
• Ehemaliger Antragsteller: Professor Dr. Michael Molls, until 3/2014