Abstract
BACKGROUND AND PURPOSE: Tumor hypoxia is a known factor of radioresistance in HNSCC. CTP is a noninvasive method of measuring tumor perfusion in vivo. The purpose of our study was to determine serial changes in tumor perfusion in HNSCC during a course of RT by using CTP and to correlate tumor perfusion measurements to LRC.
MATERIALS AND METHODS: A prospective study was performed in 15 patients with HNSCC receiving definitive RT who underwent serial CTP before RT; at weeks 2, 4, and 6 of RT; and 6 weeks after RT. The median follow-up was 28 months (range, 6–44 months). Thirteen patients achieved LRC, and 2 patients had LRF. Tumor perfusion parameters, including BF, BV, MTT, and CP, were obtained by using a deconvolution-based analysis.
RESULTS: Pretreatment tumor BF was significantly higher in patients who achieved LRC, 118.0 mL/100 g/min, compared with those with LRF, 53.4 mL/100 g/min (P = .004). Similarly, pretreatment CP was higher in patients with LRC, 16.6 mL/100 g/min, compared with those with LRF, 7.7 mL/100 g/min (P = .02). At week 2 of RT, tumor BF parameters showed a 27.5% increase versus an 18.1% decrease from pretreatment BF values (P = .046) in patients with LRC and LRF, respectively. A decrease in BF and BV was observed in both groups 6 weeks after RT compared with these values at baseline scanning.
CONCLUSIONS: An increase in tumor BF and CP by using CTP early during a course of RT predicts LRC in patients with HNSCC treated with RT.
Abbreviations
- BF
- blood flow
- BV
- blood volume
- CP
- capillary permeability surface product
- CTP
- CT perfusion
- 3D-CRT
- 3D radiotherapy
- FDG
- fluorodeoxyglucose
- GTV
- gross tumor volume
- HNSCC
- head and neck squamous cell carcinoma
- IMRT
- intensity-modulated radiation therapy
- LRC
- locoregional control
- LRF
- locoregional failure
- M
- metastasis
- MTT
- mean transit time
- N
- node
- PET
- positron-emission tomography
- RT
- radiotherapy
- SCC
- squamous cell carcinoma
- SUV
- standardized uptake value
- T
- tumor
- VEGF
- vascular endothelial growth factor
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