Abstract
PurposeThis study is to investigate the use of dynamic contrast-enhanced magnetic resonance imaging in predicting early response to CRT (chemo-radiotherapy) in patients with larynx and hypopharynx carcinoma from primary tumors.MethodSixty-two patients with larynx and hypopharynx carcinoma underwent two DCE-MRI studies: a baseline exam before any treatmentanda post-treatment exam 3 weeks after CRT. At the end of treatment, patients were classified as responders, or non-responders according to the Response Evaluation Criteria in Solid Tumors criteria (RECIST). The time intensity curves (TIC) were extracted and processed to obtain time to peak (TTP), maximum slope of increase (MSI), maximum slope of decrease (MSD) and positive enhancement integral (PEI), and the semi-quantitative MRI parameters were compared and analyzed between the two groups.ResultsFifty-four and 8 patients were included the responder and non-responder groups. It was observed that the MSI, MSD, and PEI were significantly lower post-treatment than pre-treatment(P < 0.05). The pretreatment MSI, MSD, and PEI parameters of responders were significantly higher than those of non-responders (P< 0.05). The post-treatment MSI, MSD, and PEI parameters of responders were significantly lower than those of non-responders (P< 0.05). Based on ROC curve analysis, at a threshold of 154.81 for pretreatment MSI, the corresponding AUC, sensitivity, and specificity were 0.882, 89.3% and 73.5%, respectively.ConclusionThe semi-quantitative DCE-MRI may aid in the prediction of early response to CRT in patients with larynx and hypopharynx carcinoma.
Highlights
Larynx and hypopharynx carcinoma are common malignant neoplasms in head and neck squamous cell carcinoma (HNSCC)
It was observed that the maximum slope of increase (MSI), maximum slope of decrease (MSD), and positive enhancement integral (PEI) were significantly lower posttreatment than pre-treatment(P < 0.05)
The use of semi-quantitative parameters derived from DCE-MR imaging data for prediction of treatment response to chemo-radiation therapy in patients with larynx and hypopharynx carcinoma was investigated
Summary
Larynx and hypopharynx carcinoma are common malignant neoplasms in head and neck squamous cell carcinoma (HNSCC). The incidence of hypopharynx carcinoma was lower than that of larynx carcinoma. Radiation therapy and concurrent or induction chemotherapy is the standard treatment for organ preservation in larynx and hypopharynx carcinoma [2,3]. Not all patients with larynx and hypopharynx carcinoma respond to chemo-radiotherapy. Resistance to chemo-radiotherapy is widely recognized as the main cause of relapse for larynx and hypopharynx carcinoma. Biomarkers that may predict treatment outcome and stratify patients that would benefit from chemo-radiation www.impactjournals.com/oncotarget therapy is of great clinical significance. Alternative treatment strategies such as upfront neck surgery and novel treatment modalities that include monoclonal antibodies, molecular inhibitors, and gene therapy can be individually tailored to improve survival and quality of life [4]
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