Department of Cranio-, Maxillofacial and Oral Surgery 8090 Zürich SwitzerlandRekrutierend» Google-Maps Ansprechpartner: Christine Hager E-Mail: christine.hager@usz.ch» Ansprechpartner anzeigen
The incidence of head and neck squamous cell cancer (HNSCC) is around 600 000 cases per year
worldwide. The main sites for HNSCC are the larynx, the pharynx and the oral cavity. Head and
neck cancers, however, also include salivary gland tumours, as well as nasopharyngeal cancer
and paranasal and nasal sinus cancer but these are rare. The major risk factors are smoking,
alcohol abuse and Human Papillomavirus (HPV) infection. In spite of radical surgical
treatment and aggressive neo-adjuvant and adjuvant therapies, the prognosis of head and neck
cancer is very poor due to the fact that the tumours are often hypoxic.
Tumour hypoxia is heterogenous and results from an imbalance between oxygen supply and oxygen
consumption. Acute hypoxia is caused by abnormal structure and function of the
microvasculature supplying the tumour. Chronic hypoxia is caused by the increased distance
through which the oxygen has to diffuse to get from the blood vessels to the tumour cells and
by the reduced oxygen caused by the anaemia which can be treatment or disease-related. These
hypoxic regions have been shown to affect the metabolism of the cells, making them more
aggressive with increased risk of metastasis and a worse prognosis. Also, because
radiotherapy relies on oxygen to cause maximal cytotoxicity, a lack of oxygen to the cells or
even a lack of oxygen consumption by the cells would cause a decrease in the effectiveness of
the radiotherapy and the cytotoxicity. Hypoxic cells have an acidic environment which affects
drug delivery and drug activity, so chemotherapy is compromised.
In order to predict outcome and identify patients with a worse prognosis or patients that
would benefit from appropriate treatments, in vivo measurement of tumour hypoxia is required.
Numerous methods have been explored but there is no accepted gold standard. Imaging and
biomarker analysis have been shown to have potential but the data are insufficient. In this
project the investigators would prospectively use existing imaging techniques and analysis of
various bodily fluids to predict outcome. This is a collaboration between 5 different
departments so that as much information as possible can be analysed and used to come to a
possible solution.
- Interdisciplinary Head and neck tumour board (USZ) confirmed inclusion in the project
- For patients with reproductive potential (e.g. female participants who are surgically
sterilised/hysterectomised or post-menopausal for longer than 2 years are not
considered as beig of child bearing potential), a willingness to use adequate
contraceptive measures to prevent pregnancy during the project.
Exclusion Criteria:
- Pregnant or breastfeeding
- Suffers from claustrophobia
- Known allergy to Pimonidazole
- Participation in a study with an investigational drug within the 30 days preceding and
during this project
- Tumour size smaller than 1cm
- Has symptomatic Chronic Obstructive Pulmonary Disease (COPD)
- Patient refuses or is unable to give a written informed consent
- Previous treatment for head and/or neck cancer
- Inability to follow the procedures of the project e.g. due to language problems,
psychological disorders, dementia, etc. of the participant.
1. Disease-specific and overall survival correlated with tumour hypoxia (Time Frame - 5-years): Tumour hypoxia will be determined from the Pimonidazole staining and this will be correlated to disease-specific survival and overall survival. The study has been approved for 10 participants to be increased by the ethical committee to 100 once the study is going.
