Radiation Biology

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SU_41_2413 - Detection of Circulating Tumor Cells During Radiation Therapy in Patients With Head and Neck Cancer

Sunday, October 21
1:15 PM - 2:45 PM
Location: Innovation Hub, Exhibit Hall 3

Detection of Circulating Tumor Cells During Radiation Therapy in Patients With Head and Neck Cancer
S. P. Ng1, S. Meas1, H. Bahig1, H. D. Skinner1, A. S. Garden1, J. Phan1, D. I. Rosenthal1, G. B. Gunn1, S. J. Frank1, W. H. Morrison1, E. M. Sturgis1, R. Ferrarotto1, C. D. Fuller1, A. Lucci2, and C. S. Hall1; 1The University of Texas MD Anderson Cancer Center, Houston, TX, 2MD Anderson, Houston, TX

Purpose/Objective(s): The detection of circulating tumor cells (CTCs) has been shown to correlate with disease recurrence in many cancer types. Recent investigations in other tumor sites suggested that CTCs can be mobilized from the irradiated tumor. Our pilot study aimed to assess the feasibility of detecting circulating tumor cells (CTCs) during radiotherapy in patients with head and neck cancer and to evaluate if CTC may be released into the circulation during radiotherapy.

Materials/Methods: Patients with localized mucosal head and neck squamous cell carcinomas undergoing definitive radiotherapy were eligible for enrolment on a prospective observational study. Peripheral blood samples were collected pre-radiotherapy, post first fraction of radiotherapy, weekly during radiotherapy and at 8 to 12 weeks post-treatment. CTCs were assessed and quantified using the FDA-approved CellSearch System. Patient, tumor and treatment characteristics were recorded.

Results: A total of 11 patients enrolled on the study. Out of the 11 patients with pre-treatment CTC analysis, only 2 were positive for CTCs. Three patients with no detectable CTC pre-treatment were positive for CTCs after first fraction of radiotherapy. Six patients completed the study with a total of 9 blood samples collected each. Five out of 6 patients who completed the study had CTCs detected during radiotherapy, particularly after week 2 of treatment. Three patients had CTCs detected in their final week of treatment course. One patient did not have any CTC detected throughout the treatment course. None of the 6 patients had detectable CTCs at 8 to 12 weeks post-treatment. All 6 patients who completed the study achieved complete tumor response at the 8- to 12-week post-treatment assessment.

Conclusion: Our study showed that CTCs can be detected during radiotherapy in patients with mucosal head and neck cancer using the CellSearch System. The detection of CTCs during radiotherapy in patients with undetectable CTC count pre-treatment suggests that radiation may have mobilized tumor cells into the circulation. The clinical significance of this finding warrants further investigation and longer follow up is required for these patients to assess clinical outcomes.

Author Disclosure: S. Ng: Employee; The University of Texas MD Anderson Cancer Center. Research Grant; RSNA, RANZCR. S. Meas: None. H. Bahig: None. H.D. Skinner: None. A.S. Garden: None. D.I. Rosenthal: Advisory Board; BMS. G.B. Gunn: Associate Medical Director; MD Anderson Cancer Center - Proton Therapy. S.J. Frank: Research Grant; C4 Imaging, ELEKTA, U19. Founder and Director; C4 Imaging. Honoraria; ELEKTA, Varian Medican Systems, Inc. Advisory Board; Varian Medican Systems, Inc. Stock; C4 Imaging. Royalty; C4 Imaging. Patent/License Fees/Copyright; C4 Imaging. Chairman; American Brachytherapy Society. Director; C4 Imaging. Director-at-large; North America Skull Base Society. W.H. Morrison: Advisory Board; Regeneron. Stock; Merck, Baxter, Johnson and Johnson. Member; NCCN Nonmelanoma Skin and Merkel Cell Committees. R. Ferrarotto: None. C.D. Fuller: Research Grant; National Institutes of Health, National Science Foundation, Elekta AB. Grant funding; Elekta AB. Honoraria; Nederlandse Organisatie voor Wetenschappelijk Onde. Consultant; Elekta AB, Nederlandse Organisatie voor Wetenschappelijk Onde. Travel Expenses; Elekta AB, Nederlandse Organisatie voor Wetenschappelijk Onde. Reviewer; Radiological Society of North America. Associate Editor; Radiographics. Data Management Task Force Committee Member; MR-LinAc Consortium. Member; National Cancer Institute. Task Group Member; American Association of Physicists in Medicine. C.S. Hall: None.

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