Role of energy spectrum parameters in predicting the effect of radiotherapy with or without chemotherapy in treatment of locally advanced laryngeal and hypopharyngeal squamous cell carcinoma

Abstract

Objective To investigate the role of dual-energy scanned projection CT (dSPCT) in predicting the effect of radiotherapy with or without chemotherapy in the treatment of locally advanced laryngeal and hypopharyngeal squamous cell carcinoma (LHSCC). Methods A prospective analysis was performed for the clinical data of 23 patients with primary LHSCC who underwent dSPCT from 2013 to 2014. According to treatment outcome, the patients were divided into complete remission (CR) group and non-complete remission (NCR) group. The T stage, treatment modality, iodine concentration of lesion (IC-L), water concentration of lesion (WC-L), and slope of spectral HU curve (s-SHC) were compared between the two groups, and the receiver operating characteristic (ROC) curve was also used for analysis. Results There were no significant differences in T stage and treatment modality between the CR group and NCR group (P=0.54 and P=1.00). The IC-L was (15.89±4.08)×102 μg/cm3 and (20.43±5.98)×102 μg/cm3, respectively, in the two groups (P=0.04), and the WC-L was similar between the two groups (P=0.32). The s-SHC was 2.16±0.55 and 2.77±0.81, respectively, in the two groups (P=0.04). The areas under the ROC curve for IC-L and s-SHC were 0.74 and 0.72, respectively (P=0.03 and P=0.04). The sensitivity, specificity, Youden index, positive likelihood ratio, and negative likelihood ratio of IC-L≤17.44 and s-SHC≤2.37 as the standard for CR in LHSCC were 75.0%, 72.7%, 0.47, 2.75, and 0.34, respectively. Conclusions The dSPCT plays a role in predicting the treatment outcome of locally advanced LHSCC. Key words: Radiography, dual-energy scanned projection; Carcinoma, squamous cell; Receiver operating characteristic curve