PhD ceremony Mr. M.L. Schrijvers: New prognostic markers to predict clinical outcome in patients with laryngeal cancer

PhD ceremony: Mr. M.L. Schrijvers, 14.30 uur, Academiegebouw, Broerstraat 5, Groningen

Dissertation: New prognostic markers to predict clinical outcome in patients with laryngeal cancer

Promotor(s): prof. B.F.A.M. van der Laan, prof. E. Schuuring

Faculty: Medical Sciences

Head and neck squamous cell carcinoma (HNSCC) is the fifth most common cancer in the world with an incidence of over 600.000 cases per year and yearly mortality of 350.000. Twenty percent of all head and neck tumours originate in the larynx, of which the majority is located in the glottic region. Most early stage (T1/T2) laryngeal carcinomas are treated with conservative (laser) surgery or (accelerated) radiotherapy. For more advanced tumours (T3/T4), surgery and/or chemoradiotherapy is the treatment of choice. Until now, the choice of treatment is mainly based on well-known clinicopathological factors, such as tumour location and tumour stage. Cell biological tumour markers associated with response to treatment or prognosis might be useful to predict clinical outcome before treatment, and thereby optimize and personalize the treatment for individual patients. In this thesis, cell biological tumour markers involved in loco regional control, overall survival, disease specific survival and lymph node status in patients with laryngeal squamous cell carcinoma treated with radiotherapy were investigated. Of these tumour markers, high pFADD expression and low HIF1a and CA-IX expression were significantly associated with better local control after radiotherapy. High EGFR expression was associated with lymph node positivity. This research reveals new insights into the molecular mechanisms of response to radiotherapy and clinical outcome in mainly early stage laryngeal carcinomas. The development of predictive molecular profiles may facilitate the optimal treatment strategy for each patient. Our results may contribute to the selection of patients who might benefit from adding chemotherapy, EGFR blocking agents or hypoxic modification to the current standard (accelerated) radiotherapy.