Early prediction of outcome in advanced head-and-neck cancer based on tumor blood volume alterations during therapy: a prospective study.

Abstract

PURPOSE:

To assess whether alterations in tumor blood volume (BV) and blood flow (BF) during the early course of chemo-radiotherapy (chemo-RT) for head-and-neck cancer (HNC) predict treatment outcome.

METHODS AND MATERIALS:

Fourteen patients receiving concomitant chemo-RT for nonresectable, locally advanced HNC underwent dynamic contrast-enhanced (DCE) MRI scans before therapy and 2 weeks after initiation of chemo-RT. The BV and BF were quantified from DCE MRI. Preradiotherapy BV and BF, as well as their changes during RT, were evaluated separately in the primary gross tumor volume (GTV) and nodal GTV for association with outcomes.

RESULTS:

At a median follow-up of 10 months (range, 5-27 months), 9 patients had local-regional controlled disease. One patient had regional failure, 3 had local failures, and 1 had local-regional failure. Reduction in tumor volume after 2 weeks of chemo-RT did not predict for local control. In contrast, the BV in the primary GTV after 2 weeks of chemo-RT was increased significantly in the local control patients compared with the local failure patients (p < 0.03).

CONCLUSIONS:

Our data suggest that an increase in available primary tumor blood for oxygen extraction during the early course of RT is associated with local control, thus yielding a predictor with potential to modify treatment. These findings require validation in larger studies.

• Authors: Yue Cao, Aron Popovtzer, Diana Li, Douglas B Chepeha, Jeffrey S Moyer, Mark E Prince, Francis Worden, Theodoros Teknos, Carol Bradford, Suresh K Mukherji, Avraham Eisbruch
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 72 Issue 5 Pg. 1287-90 (Dec 01 2008) ISSN: 1879-355X [Electronic] United States
• PMID: 19028268 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)

Chemical References

• Antibodies, Monoclonal
• Antibodies, Monoclonal, Humanized
• Carboplatin
• Paclitaxel
• Cetuximab

Topics

• Adult
• Aged, 80 and over
• Antibodies, Monoclonal (administration & dosage)
• Antibodies, Monoclonal, Humanized
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Blood Volume (radiation effects)
• Carboplatin (administration & dosage)
• Cetuximab
• Combined Modality Therapy
• Female
• Follow-Up Studies
• Head and Neck Neoplasms (blood supply, drug therapy, mortality, pathology, radiotherapy)
• Humans
• Male
• Middle Aged
• Paclitaxel (administration & dosage, therapeutic use)
• Predictive Value of Tests
• Radiotherapy Dosage
• Time Factors
• Treatment Failure
• Treatment Outcome