van den Broek et al developed models for predicting outcome for patients with advanced head and neck cancer treated with targeted chemoradiation. The model for 2 year local control uses variables available prior to treatment and can help identify patients who may require more aggressive management. The authors are from the Netherlands Cancer Institute at Antoni Van Leeuwenhoek Hospital in Amsterdam, The Netherlands.
Patient selection: T3 or T4 head and neck carcinoma with ASA class I, II or III.
Parameters:
(1) age of the patient in years
(2) tumor volume in cubic cm (mL)
(3) N classification
(4) T classification
(5) oral cavity involvement
(6) oropharynx involvement
(7) infusion mode
|
Parameter |
Finding |
Points |
|
T classification |
T3 |
4.3 |
|
|
T4 |
0 |
|
N classification |
N0 or N1 |
7.7 |
|
|
N2 or N3 |
0 |
|
oral cavity involvement |
no |
2.6 |
|
|
yes |
0 |
|
oropharynx involvement |
no |
8.5 |
|
|
yes |
0 |
|
intra-arterial infusion mode |
unilateral |
0 |
|
|
bilateral |
12.7 |
|
Tumor Volume |
Points |
|
0 mL |
0 |
|
50 mL |
6.8 |
|
100 mL |
19.2 |
|
150 mL |
32.8 |
|
200 mL |
46.3 |
|
250 mL |
59.7 |
|
300 mL |
73.1 |
|
350 mL |
86.5 |
|
400 mL |
99.1 |
points for volume 0 to 50 mL =
= (0.136 * (volume in mL))
points for volume 50 to 400 mL =
= (0.26593 * (volume in mL)) - 6.8964
|
Age of the Patient |
Points |
|
25 years of age |
0.1 |
|
30 years of age |
1.1 |
|
35 years of age |
2.2 |
|
40 years of age |
2.9 |
|
45 years of age |
3.9 |
|
50 years of age |
5.6 |
|
55 years of age |
8.1 |
|
65 years of age |
10.2 |
|
75 years of age |
9.8 |
|
80 years of age |
8.5 |
points for age 25 to 45 =
= (0.188 * (age in years)) - 4.54
points for age 45 to 65 =
= (-0.008091 * ((age in years)^2) + (1.2146 * (age in years)) - 34.519
points for age 65 to 75 =
= (-0.04 * (age in years)) + 12.8
points for age 75 to 80 =
= (-0.26 * (age in years)) + 29.3
total score =
= SUM(points for all 7 parameters)
The probability of 2 year local control is read off the graph in Figure 2. This can be approximated by the formula:
probability of 2 year survival =
= > 95% if points < 15
= < 6% if points > 45
= ((-0.091732 * ((points)^2)) + (2.483716 * (points)) + 78.512587) / 100 * 100%
Specialty: Hematology Oncology, Surgery, general, Otolaryngology
