The aim of the study is to prospectively evaluate whether markers of a patient's systemic inflammatory response in addition to FDG-PET/CT metabolic parameters of the primary tumor or of nodal metastases can predict radioresistance and survival before primary radiochemotherapy in advanced head and neck cancer patients.

This study prospectively investigates pretherapeutic markers of systemic inflammatory response (including neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, systemic inflammation response index, and systemic immune-inflammation) and FDG-PET/CT-derived metabolic parameters of tumor and nodal metastases (including maximum standardized uptake value, metabolic tumor volume, and total lesion glycolysis) and their potential prognostic value in head and neck cancer patients prior to primary radiochemotherapy.

Inclusion Criteria:

• histopathologic diagnosis of squamous cell carcinoma of the head and neck
• primary radio(chemo)therapy with curative intent
• available pretherapeutic FDG-PET/CT imaging
• available pretherapeutic differential blood analysis

Exclusion Criteria:

• other tumor entities of the head and neck including cutaneous squamous cell carcinoma
• primary surgical treatment
• ongoing infections or other inflammatory diseases at the time of diagnosis
• patients not completing a course of irradiation with at least 66 Gray locally

All patients undergoing primary radio(chemo)therapy for oral, oropharyngeal, epipharyngeal, hypopharyngeal or laryngeal squamous cell carcinoma at Cantonal Hospital Lucerne, Switzerland