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Title: Changes in perfusion CT of advanced squamous cell carcinoma of the head and neck treated during the course of concomitant chemoradiotherapy
Authors: Šurlan-Popovi?, K.Š
Bisdas, S
Rumboldt, Z
Koh, T.S 
Strojan, P
Keywords: cisplatin
advanced cancer
cancer chemotherapy
cancer radiotherapy
clinical article
computer assisted tomography
head and neck carcinoma
mouth cavity
multimodality cancer therapy
prospective study
radiation dose
squamous cell carcinoma
treatment outcome
tumor volume
Antineoplastic Agents
Carcinoma, Squamous Cell
Combined Modality Therapy
Drug Monitoring
Head and Neck Neoplasms
Middle Aged
Predictive Value of Tests
Prospective Studies
ROC Curve
Tomography, X-Ray Computed
Issue Date: 2010
Publisher: American Society of Neuroradiology
Citation: Šurlan-Popovi?, K.Š, Bisdas, S, Rumboldt, Z, Koh, T.S, Strojan, P (2010). Changes in perfusion CT of advanced squamous cell carcinoma of the head and neck treated during the course of concomitant chemoradiotherapy. American Journal of Neuroradiology 31 (3) : 570-575. ScholarBank@NUS Repository.
Rights: Attribution 4.0 International
Abstract: BACKGROUND AND PURPOSE: Concomitant chemoradiation is a promising therapy for the treatment of locoregionally advanced head and neck carcinoma. The purpose of this study was to prospectively evaluate early changes in primary tumor perfusion parameters during concomitant cisplatin-based chemoradiotherapy of locoregionally advanced SCCHN and to evaluate their predictive value for response of the primary tumor to therapy. MATERIALS AND METHODS: Twenty patients with locoregionally advanced SCCHN underwent perfusion CT scans before therapy and after completion of 40 Gy and 70 Gy of chemoradiotherapy. BF, BV, MTT, and PS of primary tumors were quantified. Differences in perfusion and tumor volume values during the therapy as well as between responders and nonresponders were analyzed, and ROC curves were used to assess predictive value of the baseline and follow-up functional parameters. RESULTS: The tumor volumes at 40 Gy and at 70 Gy were significantly lower compared with baseline values (P = .014 and P = .007). In the 6 nonresponders, measurements after 40 Gy showed a nonsignificant trend of increased BF, BV, and PS values compared with the baseline values (P = .06). In 14 responders, a significant reduction of BF values was recorded after 40 Gy (P = .04) and after 70 Gy (P = .01). In responders, BV values showed a reduction after 40 Gy followed by a plateau after 70 Gy (P = .04), whereas in nonresponders there was a nonsignificant elevation of the BV. Baseline BV predicted shortterm tumor response with a sensitivity of 60% and specificity of 100% (P = .01). After completion of 40 Gy of concomitant chemoradiation BV was a more significant predictor than were BF and MTT. CONCLUSIONS: The results suggest that in advanced SCCHN the perfusion CT monitoring might be of predictive value for identifying tumors that may respond to cisplatin-based chemoradiotherapy.
Source Title: American Journal of Neuroradiology
ISSN: 0195-6108
DOI: 10.3174/ajnr.A1859
Rights: Attribution 4.0 International
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