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A failure-type specific risk prediction tool for selection of head-and-neck cancer patients for experimental treatments

Research output: Contribution to journalArticle

Katrin Håkansson, Jacob H Rasmussen, Gregers B Rasmussen, Jeppe Friborg, Thomas A Gerds, Barbara Malene Fischer, Flemming L Andersen, Søren M Bentzen, Lena Specht, Ivan R Vogelius

Original languageEnglish
Pages (from-to)77-82
Number of pages6
Publication statusPublished - 1 Nov 2017

Bibliographical note

Copyright © 2017 Elsevier Ltd. All rights reserved.

King's Authors


OBJECTIVES: The objective of this work was to develop a tool for decision support, providing simultaneous predictions of the risk of loco-regional failure (LRF) and distant metastasis (DM) after definitive treatment for head-and-neck squamous cell carcinoma (HNSCC).MATERIALS AND METHODS: Retrospective data for 560HNSCC patients were used to generate a multi-endpoint model, combining three cause-specific Cox models (LRF, DM and death with no evidence of disease (death NED)). The model was used to generate risk profiles of patients eligible for/included in a de-intensification study (RTOG 1016) and a dose escalation study (CONTRAST), respectively, to illustrate model predictions versus classic inclusion/exclusion criteria for clinical trials. The model is published as an on-line interactive tool ( The final model included pre-selected clinical variables (tumor subsite, T stage, N stage, smoking status, age and performance status) and one additional variable (tumor volume). The treatment failure discrimination ability of the developed model was superior of that of UICC staging, 8(th) edition (AUCLRF=72.7% vs 64.2%, p20% risk of tumor relapse. Conversely, 9 of the 15 dose escalation trial participants had LRF risks

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