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Peer-reviewedCC BYCommunications Medicine

Prospective evaluation of oxygen saturation endoscopic imaging for radiotherapy response in head and neck cancer

  • Kento Tomizawa1
  • Atsushi Motegi1
  • Hidenari Hirata1
  • Hiroki Yamashita2
  • Hironori Sunakawa2
  • Yusuke Yoda3
  • Wataru Okano4
  • Tomohiro Enokida5
  • Takeshi Fujisawa1
  • Masaki Nakamura1
  • Hidehiro Hojo1
  • Seiichiro Abe6
9 more authors
  • Madoka Sakuramachi7
  • Hiroshi Igaki7
  • Yutaka Saito6
  • Shingo Sakashita8
  • Kazuto Matsuura4
  • Makoto Tahara5
  • Tomonori Yano2
  • Sadamoto Zenda1
  • Tetsuo Akimoto1
8 affiliations
  1. 1Department of Radiation Oncology, National Cancer Center Hospital East
  2. 2Department of Gastroenterology and Endoscopy, National Cancer Center Hospital East
  3. 3Division of Endoscopy, Saitama Cancer Center
  4. 4Department of Head and Neck Surgery, National Cancer Center Hospital East
  5. 5Department of Head and Neck Medical Oncology, National Cancer Center Hospital East
  6. 6Endoscopy Division, National Cancer Center Hospital
  7. 7Department of Radiation Oncology, National Cancer Center Hospital
  8. 8Division of Pathology, Exploratory Oncology Research & Clinical Trial Center, National Cancer Center
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Abstract

Background We developed an endoscopic imaging technology, oxygen saturation imaging (OS imaging), to assess real-time tissue oxygenation levels. However, its clinical impact remains unclear. This prospective observational study evaluated the association between pretreatment tumor oxygen saturation (StO2) quantified by OS imaging and the outcomes of patients with head and neck squamous cell carcinoma (HNSCC) receiving radiotherapy (RT). Methods The primary endpoint was the association between pretreatment tumor StO2 and complete response rate at 8 weeks after RT completion. Secondary endpoints were the impact of StO2 on 1-year overall survival, progression-free survival, and local failure rates. Results Of 50 patients with HNSCC enrolled from 2019 to 2022, 42 who underwent RT and OS imaging are analyzed. Of those, 41 received concurrent platinum-based chemotherapy. Median pretreatment StO2 is significantly lower in tumor tissue than in normal mucosa (61% vs. 66%, respectively). Complete response rates at 8 weeks after RT are not significantly different between the hypoxia (StO2 ≤ 61%, n = 22) and non-hypoxia (StO2 > 61%, n = 20) groups (86% vs. 100%, respectively). After a median follow-up of 36 (range: 9–53) months, the hypoxia group has significantly worse 1-year overall survival (91% vs. 100%), progression-free survival (77% vs. 95%), and local failure (18% vs. 5%) rates than the non-hypoxia group. Conclusions Despite not meeting the primary endpoint, our findings suggest that pretreatment tumor StO2 is correlated with 1-year outcomes after RT, and OS imaging may be useful for identifying RT-resistant hypoxic tumors in HNSCC.

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Cite

BibTeXRIS
BibTeX
@article{tomizawa2026prospective,
  title = {{Prospective evaluation of oxygen saturation endoscopic imaging for radiotherapy response in head and neck cancer}},
  author = {Kento Tomizawa and Atsushi Motegi and Hidenari Hirata and Hiroki Yamashita and Hironori Sunakawa and Yusuke Yoda and Wataru Okano and Tomohiro Enokida and Takeshi Fujisawa and Masaki Nakamura and Hidehiro Hojo and Seiichiro Abe and Madoka Sakuramachi and Hiroshi Igaki and Yutaka Saito and Shingo Sakashita and Kazuto Matsuura and Makoto Tahara and Tomonori Yano and Sadamoto Zenda and Tetsuo Akimoto},
  journal = {Communications Medicine},
  year = {2026},
  month = jul,
  doi = {10.1038/s43856-026-01752-x},
  url = {https://doi.org/10.1038/s43856-026-01752-x},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Prospective evaluation of oxygen saturation endoscopic imaging for radiotherapy response in head and neck cancer
AU  - Kento Tomizawa
AU  - Atsushi Motegi
AU  - Hidenari Hirata
AU  - Hiroki Yamashita
AU  - Hironori Sunakawa
AU  - Yusuke Yoda
AU  - Wataru Okano
AU  - Tomohiro Enokida
AU  - Takeshi Fujisawa
AU  - Masaki Nakamura
AU  - Hidehiro Hojo
AU  - Seiichiro Abe
AU  - Madoka Sakuramachi
AU  - Hiroshi Igaki
AU  - Yutaka Saito
AU  - Shingo Sakashita
AU  - Kazuto Matsuura
AU  - Makoto Tahara
AU  - Tomonori Yano
AU  - Sadamoto Zenda
AU  - Tetsuo Akimoto
PY  - 2026
DA  - 2026/07/01
JO  - Communications Medicine
DO  - 10.1038/s43856-026-01752-x
UR  - https://doi.org/10.1038/s43856-026-01752-x
AB  - Background We developed an endoscopic imaging technology, oxygen saturation imaging (OS imaging), to assess real-time tissue oxygenation levels. However, its clinical impact remains unclear. This prospective observational study evaluated the association between pretreatment tumor oxygen saturation (StO2) quantified by OS imaging and the outcomes of patients with head and neck squamous cell carcinoma (HNSCC) receiving radiotherapy (RT). Methods The primary endpoint was the association between pretreatment tumor StO2 and complete response rate at 8 weeks after RT completion. Secondary endpoints were the impact of StO2 on 1-year overall survival, progression-free survival, and local failure rates. Results Of 50 patients with HNSCC enrolled from 2019 to 2022, 42 who underwent RT and OS imaging are analyzed. Of those, 41 received concurrent platinum-based chemotherapy. Median pretreatment StO2 is significantly lower in tumor tissue than in normal mucosa (61% vs. 66%, respectively). Complete response rates at 8 weeks after RT are not significantly different between the hypoxia (StO2 ≤ 61%, n = 22) and non-hypoxia (StO2 > 61%, n = 20) groups (86% vs. 100%, respectively). After a median follow-up of 36 (range: 9–53) months, the hypoxia group has significantly worse 1-year overall survival (91% vs. 100%), progression-free survival (77% vs. 95%), and local failure (18% vs. 5%) rates than the non-hypoxia group. Conclusions Despite not meeting the primary endpoint, our findings suggest that pretreatment tumor StO2 is correlated with 1-year outcomes after RT, and OS imaging may be useful for identifying RT-resistant hypoxic tumors in HNSCC.
SN  - 2730-664X
ER  -