Early Response Assessment on Mid-treatment Computed Tomography Predicts for Locoregional Recurrence in Oropharyngeal Cancer Patients Treated With Definitive Radiation Therapy

International Journal of Radiation Oncology, Biology, Physics
Rafi KabarritiMadhur K Garg

Abstract

To evaluate whether a response assessment using mid-treatment computed tomography (CT) scans during definitive radiation therapy (RT) for oropharyngeal head and neck cancer can predict for locoregional recurrence (LRR). Head and neck cancer patients who receive RT at our institution undergo CT repeat scans at the 15th fraction, with treatment replanning in the case of an inadequate dose to gross disease or an increased dose to organs at risk. A retrospective cohort analysis was performed of 96 consecutive patients with oropharyngeal cancer treated from 2007 to 2015 with mid-treatment repeat CT scans available. The primary disease volume and involved lymph node volume were delineated on the pre- and mid-treatment CT scans. Univariable and multivariable Cox proportional hazards regression analyses were used to evaluate the efficacy of the mid-treatment reduction in tumor volume as a predictor of LRR. Risk stratification was performed by dichotomizing the patients into high- and low-risk groups according to the mid-treatment response and p16 status and smoking history. With a median follow-up of 34 months, 14 patients experienced LRR. The median reduction in the total tumor volume was 18.7% (interquartile range 8.4%-30.9%). A redu...Continue Reading

Citations

Aug 20, 2019·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Jia WuRuijiang Li

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