A prospective study to assess for the prognostic value of tumour volume reduction rate in head and neck cancer, during definitive chemo-radiation in a tertiary care hospital.

Abstract

Tumour volume (TV) is an important factor influencing Radiation therapy(RT) outcome of patients. Logically, total dose and its fractionation should be tailored to the initial number of tumor cells which strongly correlated with tumor volume (TV) rather than to the tumor diameter or stage T. Aims and objectives: To assess tumour volume reduction rate weekly in patients with biopsy proven head and neck cancers treated with definitive chemo-radiation ant to correlate with histology haemoglobin and BMI . Methods and Materials: All oral cavity, oropharyngeal, hypopharyngeal, nasopharyngeal, and laryngeal cancer patients meeting inclusion criteria were included after obtaining informed written consent. All patients received definitive chemoradiation with weekly CT scanning of head and neck for the assessment of tumour and nodal volume response to chemoradiation. Tumour volume was contoured every week on CT scanning images. Tumour volume response rate (TVRR) was calculated. Results: Fourty patients were recruited. Most tumours were MDSCC accounting for 55%. Phase 1 TVRR was marginal which steeply increase 3rd week onwards during chemoradiation. In the phase 2, TVRR increased markedly. The mean TVRR on week 7 for WDSCC, MDSCC and PDSCC were 14.38 ± 7.01%, 15.01 ± 7.95% and 19.82 ± 10.44% respectively. The maximum TVRR was observed on the 7 th week of treatment which is the last week of treatment period. Patients with PDSCC had higher TVRR . Conclusion: Our study demonstrated TVVR increased markedly third week onwards and it was found to be maximum at 7th week .