Predictive markers for local control in early-stage laryngeal cancer primarily treated with radiotherapy
| PhD ceremony: | Mr E.A. (Emiel) Kop |
| When: | September 04, 2024 |
| Start: | 14:30 |
| Supervisors: | prof. dr. E.M.D. (Ed) Schuuring, prof. dr. B.F.A.M. (Bernard) van der Laan, prof. dr. G.H. (Truuske) de Bock |
| Co-supervisor: | B. (Bert) van der Vegt |
| Where: | Academy building RUG |
| Faculty: | Medical Sciences / UMCG |
Predictive markers for local control in early-stage laryngeal cancer primarily treated with radiotherapy
Head and neck squamous cell carcinoma is the eighth most common cancer globally, with 550,000 new cases and 350,000 deaths annually. In laryngeal squamous cell carcinoma (LSCC), the second-largest subgroup, yearly ~195.000 new cases are observed worldwide, including ~700 in the Netherlands.LSCC is primarily treated with definitive (chemo)radiotherapy. Despite the benefits of radiotherapy in preserving laryngeal function, recurrence rates for early-stage LSCC remain high, underlining the need for better predictive markers to improve treatment outcomes.
A comprehensive literature review identified 118 potential cellular biomarkers from 52 studies, but none shows consistent predictive value for local control post-radiotherapy. Proliferation markers like Ki-67 showed predictive value in some studies, but overall the results were inconclusive. Notably, EGFR and P53 consistently showed no predictive value. Tumor diversity, varying radiotherapy schedules, and small patient study-cohorts do not allow to draw firm conclusions on the predictive value of numerous biomarkers in early-stage laryngeal carcinoma. This underlines the need for more standardized studies.
Further evaluation of Ki-67 in a large homogenous cohort of 208 patients revealed no significant association with local control or disease-specific survival. Similarly, Major Vault Protein, despite its association with advanced tumor stages, was no reliable predictive biomarker for local control or survival in early-stage LSCC.Comparative glottic and supraglottic LSCC studies showed distinct clinicopathological and immunohistochemical characteristics, suggesting they should be treated as different entities.
These findings in this thesis of Emiel Kop underscore the urgent need for more precise biomarkers to guide personalized LSCC treatment, ultimately aiming to reduce recurrence rates and improve patient survival.