Abstract
PurposeThe aim of this study was to evaluate tumor blood flow (TBF) as a predictor of radiotherapy response for nasopharyngeal carcinoma (NPC).Materials and MethodA total of 134 patients were divided into two groups, the complete response (CR) group and the partial response (PR) group based on RECIST 1.1 recommendations. The statistical difference was evaluated for pre- and mid- or post-treatment TBF and changes of TBF for tumors and metastatic lymph nodes between CR and PR, respectively. The receiver operation characteristic (ROC) curve was utilized to evaluate the accuracy of TBF in predicting the response of radiation therapy. The association between TBF and SUVmax was also investigated.ResultsThe reduction of TBF in CR was significantly lower than that in PR for primary tumors (P <0.001) and metastatic lymph nodes (P <0.001). The multivariate logistic regression analysis indicated that the reduction of TBF is an independent predictor of the response of radiation therapy for primary tumors (P <0.001) and metastatic lymph nodes (P <0.001). The accuracy of TBF reduction in predicting the response of radiation therapy was 0.817 in primary tumors and 0.924 in metastatic lymph nodes, respectively. No significant correlation was observed between the TBF values and SUVmax of primary tumors (r = -0.008, P = 0.954) and metastasis lymph nodes (r = -0.061, P = 0.652).ConclusionThis study suggests that the reduction of TBF is a promising parameter for evaluating the response of radiation therapy.
Highlights
Nasopharyngeal carcinoma (NPC) is one of the distinctly distributional cancers and is geographically prevalent in southeast Asia and southern China [1]
A total of 99 (73.88%) primary tumors and 46 (34.33%) metastasis lymph nodes were categorized into the complete response (CR) group to radiotherapy, the remaining 35 (26.12%) and 74 (65.67%) were in the partial response (PR) group (Figure 2)
The radiotherapy response of primary tumors was significantly better than metastatic lymph nodes (P < 0.001)
Summary
Nasopharyngeal carcinoma (NPC) is one of the distinctly distributional cancers and is geographically prevalent in southeast Asia and southern China [1]. It is well known that EpsteinBarr virus (EBV) infection, host genetics, and environmental factors contribute to the occurrence of NPC, and EBV DNA testing is used to detect, prognose, and assess tumor response earlier [2, 3]. The pre-treatment EBV DNA load was correlated positively with progression of NPC after curative treatment, plasma EBV DNA immediately post treatment had the potential as a quantitative biomarker of tumor response assessment to guide the use of aggressive adjuvant chemotherapy [4]. Based on monitoring treatment response, it is essential to extract reliable prediction factors that could divide patients into low- or high-risk groups. The low-risk group may avoid ineffective therapies and prevent unnecessary adverse effects, while the high-risk group may benefit from aggressive therapies
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