Editor-in-Chief Emeritus Pick of Papers
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For each issue of Radiotherapy and Oncology, the Editor-in-Chief Emeritus Jens Overgaard, picks his favourite papers.
- Patients with locally advanced head and neck squamous cell carcinoma (HNSCC) are currently treated with postoperative radio-chemotherapy (PORT-C) or primary radio-chemotherapy. While the inclusion of chemotherapy improved the outcome significantly [1,2], treatment response is still heterogeneous. To further individualize therapy in order to improve treatment response, additional biomarkers need to be identified and applied in personalized treatment escalation or de-escalation strategies [3,4].
- Clinical trials and retrospective studies in the field of radiation oncology often consider time-to-event data as their primary endpoint. Such studies are susceptible to competing risks, i.e. competing events may preclude the occurrence of the event of interest or modify the chance that the primary endpoint occurs. Competing risks are frequently neglected and the event of interest is analysed with standard statistical methods. Here, we would like to create awareness of the problem and demonstrate different methods for survival data analysis in the presence of competing risks.
- Prognostic models are powerful tools for treatment personalisation. However, not all proposed models work well when validated using new data, despite impressive results being reported initially. Here, we will use a hands-on approach to highlight important aspects of prognostic modelling, as well as to demonstrate methods to generate generalisable models.
- Hypoxia is a well recognised parameter of tumour resistance to radiotherapy, a number of anticancer drugs and potentially immunotherapy. In a previously published exploration cohort of 25 head and neck squamous cell carcinoma (HNSCC) patients on [18F]fluoromisonidazole positron emission tomography (FMISO-PET) we identified residual tumour hypoxia during radiochemotherapy, not before start of treatment, as the driving mechanism of hypoxia-mediated therapy resistance. Several quantitative FMISO-PET parameters were identified as potential prognostic biomarkers.
- To investigate the impact of HPV status in patients with locally advanced head and neck squamous cell carcinoma (HNSCC), who received surgery and cisplatin-based postoperative radiochemotherapy.