Discovery of prognostic markers in laryngeal cancer treated with radiotherapy

Head and neck cancer is the eighth most common cancer in the world with annually 890,000 new patients. Approximately 25% of all head and neck tumors are located in the larynx. In the Netherlands, 700 new patients are observed each year. A large proportion of the laryngeal cancers are treated with radiotherapy in order to preserve the larynx (important for voice, swallowing and breathing). Unfortunately, after radiotherapy in around 25% of patients the tumor recurs. In order to improve outcome for the individual patient with laryngeal cancer, it is necessary to select those patients that will benefit from radiotherapy. Therefore, Leonie Bruine de Bruin investigated several prognostic tumor markers during her PhD-study. Because a lack of oxygen in tumor tissue (tumor hypoxia) is associated with poor response to radiotherapy in head and neck tumors, she investigated whether a specific PET scan, 18F-FAZA-PET scan, could visualize tumor hypoxia in head and neck tumors. In patients with laryngeal cancer, the relationship between the findings on the 18F-FAZA-PET scan and immunohistochemical expression of classical hypoxic markers in the same tumor tissue was also examined. Furthermore, several tumor markers are investigated in relation to the response to radiotherapy in patients with laryngeal cancer. An association was found between high expression of 3 tumor markers (PTEN, pATM and DNMT1) and poor response to treatment. Based on her findings, in future studies the use of new innovative drugs that specifically inhibit the activity of these tumor markers, might be investigate to improve treatment of laryngeal cancer.