Background and objectives: Induction chemotherapy (ICT) before definitive chemoradiation (CRT) gives high response rates in locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). However, pre-ICT gross tumor volume (GTV) for radiotherapy (RT) planning is still recommended. As ¹⁸F-FDG PET/CT has an advantage of biological tumor information comparing to standard imaging methods, we aimed to evaluate the feasibility of ¹⁸F-FDG PET/CT-based post-ICT GTV delineation for RT planning in LA-SCCHN and to assess the prognostic value of PET parameters: maximum standardized uptake value (SUV_max), metabolic tumor volume (MTV) and total lesion glycolysis (TLG). Methods: 47 LA-SCCHN patients were treated with 3 cycles of ICT (docetaxel, cisplatin, and 5-fluorouracil) followed by CRT (70 Gy in 35 fractions with weekly cisplatin). Pre- and post-ICT PET/CT examinations were acquired. Planning CT was co-registered with post-ICT PET/CT and RT target volumes were contoured according to post-ICT PET. Post-ICT percentage decrease of SUV_max, MTV and TLG in primary tumor and metastatic regional lymphnodes (LN) was counted. Loco-regional failure patterns, 3-year progression free (PFS) and overall survival (OS) were evaluated. Results: 3-year PFS and OS rates for study population were 67% and 61% respectively. 31.9% of patients progressed loco-regionally. All progress was localized in high-to-intermediate dose (60–70 Gy) RT volumes and none in low dose (50 Gy) volumes. Decrease of SUV_max ≥ 74% (p = 0.04), MTV ≥ 68% (p = 0.03), TLG ≥ 76% (p = 0.03) in primary tumor, and LN TLG decrease ≥ 74% (p = 0.03) were associated with PFS. Decrease of primary tumor SUV_max ≥ 74% (p = 0.04), MTV ≥ 69% (p = 0.03), TLG ≥ 74% (p = 0.02) and LN TLG ≥ 73% (p = 0.02) were prognostic factors for OS. Conclusions: According to our results, ¹⁸F-FDG PET/CT-based post-ICT GTV delineation is feasible strategy without negative impacts on loco-regional control and survival. Percentage decrease of metabolic PET parameters SUV_max, MTV and TLG has a prognostic value in LA-SCCHN.

Objectives: The aim of this study was to assess the impact of polymorphisms in cytokine genes on pain severity and pain treatment with palliative radiotherapy. Methods: 81 patients were enrolled. Pain severity and dose of analgesics were evaluated prior to radiotherapy and at 4, 12 and 24 weeks following treatment. The study analysed 12 gene polymorphisms of 6 cytokines (IL-6, IL-10, TNFα, IL-1α, IL-1β, IL-1RA) involved in the pathogenesis of pain syndrome. Results: Association between severe pain and patients’ variables and genotype groups of each cytokine gene studied were analysed. Karnofsky index ≥ 60 % and IL1RN rs2234677 polymorphism GG genotype were found to have significant impact on severe pain prior to radiation. Patients with IL-1α encoding gene IL1A rs1800587 CC genotype and patients with IL-1β encoding gene IL1B rs1143634 CC genotype had significantly better response to radiotherapy. Patients with IL-1RA encoding gene IL1RN rs315952 CC genotype had a faster response to radiation. Conclusions: Findings of this study emphasize the importance of gene polymorphisms which encode inflammatory interleukins in the severity of pain and response to palliative radiotherapy. Regional research ethical committee number BE-2-39 ClinicalTrials.gov registration number NCT02024815