Pre-treatment tumour perfusion parameters and initial RECIST response do not predict long-term survival outcomes for patients with head and neck squamous cell carcinoma treated with induction chemotherapy

Abstract

ObjectivesPreviously, we showed that pre-treatment tumour plasma perfusion (Fp) predicts RECIST response to induction chemotherapy (ICT) in locoregionally advanced head and neck squamous cell carcinoma (HNSCC). The aim here was to determine whether the pre-treatment tumour Fp estimate, changes in tumour Fp or RECIST response post 2 cycles of ICT were prognostic for long-term survival outcomes.MethodsA prospective study enrolled patients with high stage HNSCC treated with docetaxel (T), cisplatin (P) and 5-fluorouracil (F) (ICT) followed by synchronous cisplatin and intensity modulated radiotherapy. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) before and after two cycles of ICT was used to measure Fp and RECIST response.ResultsForty-two patients were recruited and 37 underwent two scans. The median follow-up was 36 (range 23–49) months. Pre-treatment tumour Fp (stratified by median) was not prognostic for overall survival (p = 0.42), disease specific survival (p = 0.20) and locoregional control (p = 0.64). Neither change in tumour Fp nor RECIST response post two cycles of ICT was prognostic for any outcome (p>0.21).ConclusionDCE-MRI parameters do not predict long-term survival outcomes following ICT and RECIST response to ICT may not be an appropriate endpoint to determine early efficacy of a treatment in HNSCC patients.

Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for pretreatment prediction of neoadjuvant chemotherapy response in locally advanced hypopharyngeal cancer

“…Our results and those of earlier published reports support the notion that tumors with a high perfusion status might closely better to a good response. [25][26][27][28][29][30][31][32] Lowe et al 29 reported that high pretreatment tumor perfusion evaluated using pretreatment DCE-MRI imaging in HNSCC predicts a good response to neoadjuvant chemotherapy. Kim et al 9 reported that a higher pretreatment K trans in primary cancer may predict good treatment response in patients with HNSCC underwent chemoradiation, which both agreed with our results.…”

Tumor Volume Reduction Rate to Induction Chemotherapy is a Prognostic Factor for Locally Advanced Head and Neck Squamous Cell Carcinoma: A Retrospective Cohort Study

“… 8–10 Although widely used to describe the regression status of a solid tumor, unidimensional measurement, such as RECIST, was not always a predictive value for the treatment outcome of head and neck cancer patients. 11 …”

“…[8][9][10] Although widely used to describe the regression status of a solid tumor, unidimensional measurement, such as RECIST, was not always a predictive value for the treatment outcome of head and neck cancer patients. 11 On contrary, the extent of tumor volume shrinkage after IC has been established as a prognostic factor for other cancer. In rectal cancer, preoperative tumor volume reduction after chemoradiation therapy predict disease-free survival (DFS).…”

Tumor Volume Reduction Rate to Induction Chemotherapy Is a Prognostic Factor for Locally Advanced Head and Neck Squamous Cell Carcinoma: a Retrospective Cohort Study

“…[8][9][10] Although widely used to describe the regression status of a solid tumor, unidimensional measurement, such as RECIST, was not always a predictive value for the treatment outcome of head and neck cancer patients. [11] On contrary, the extent of tumor volume shrinkage after IC have been established as a prognostic factor for other cancer. In rectal cancer, preoperative tumor volume reduction after chemoradiation therapy predict disease free survival.…”