Head and Neck Cancer Clinical Trial
Radiotherapy is an integral component of the current multimodality treatment approach in
locally advanced head and neck cancer (HNC). There is growing evidence that more aggressive
treatment regimens improve tumour control and survival. However, intensified treatment is at
the expense of increased toxicity, in particular severe acute mucositis. In addition and of
increasing importance, late and irreversible treatment-related side effects, including
xerostomia and swallowing dysfunction, occur in a considerable proportion of patients and
negatively affect quality of life.
High-risk human papilloma virus (HPV), specifically HPV type-16, is implicated as the
causative factor in a proportion of HNC, especially those of the oropharynx. HPV-related
cancers respond well to chemoradiotherapy compared to HNC related to tobacco and alcohol.
Furthermore, the incidence of HPV-related oropharyngeal cancer is rising in Western
countries. Given the significant toxicity associated with concurrent chemoradiotherapy,
subsets of patients could be managed differently.
The first objective of the project is to develop predictive models for radiation-induced
dysphagia and xerostomia in HNC patients. Clinical characteristics, treatment parameters,
dose-volume effects on healthy tissues and whole-genome genetic data will be considered. The
second objective of the project is to study the prognostic value of HPV status together with
a panel of tumour biomarkers in oropharyngeal cancer patients. The overall aim of the
project is to stratify patients according to the risks (side-effects) and benefits
(survival) of cancer treatment using the developed risk models. Clustering patients into
different risk categories may aid treatment decision making reducing therapy toxicity
without compromising survival.
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