Predictive Value of Early Post-Treatment Diffusion-Weighted MRI for Recurrence or Tumor Progression of Head and Neck Squamous Cell Carcinoma Treated with Chemo-Radiotherapy
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Data Collection and Outcomes
2.3. Diffusion-Weighted MRI
2.4. Statistical Analysis
3. Results
3.1. Patients’ Characteristics, Treatment and Follow-up
3.2. Factors Associated with Tumor Residue
3.3. Factors Associated with Post-Treatment Disease Progression or Early Recurrence
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Characteristics 1 | Value |
---|---|
Patients | |
Age at inclusion (year) − Mean ± SD | 60.8 ± 12.1 |
Sexe Ratio (M/F) | 50/9 |
Tobacco use | |
No | 8 (13.6) |
Yes | 51 (86.4) |
Active | 42 (82.4) |
weaned | 9 (17.6) |
Alcohol | 25 (42.4) |
Body Mass Index (kg/m2) − Mean ± SD | 23.9 ± 4.9 |
Head and Neck Tumor | |
Unique location | 59 (100) |
Location | |
Oropharynx | 33 (55.9) |
Oral cavity | 8 (13.6) |
Larynx | 7 (11.9) |
Hypopharynx | 8 (13.6) |
Cavum | 1 (1.7) |
Sinus | 1 (1.7) |
Parotid gland | 1 (1.7) |
HPV status (among oropharynx location) | |
Positive | 13/33 (39.4) |
Negative | 20/33 (60.6) |
TNM classification | |
T1 | 4 (6.8) |
T2 | 5 (8.5) |
T3 | 9 (15.2) |
T4 | 41 (69.5) |
N0 | 9 (15.2) |
N1 | 8 (13.6) |
N2a | 1 (1.7) |
N2b | 10 (17.0) |
N2c | 22 (37.3) |
N3 | 9 (15.2) |
M0 | 57 (96.6) |
M1 | 2 (3.4) |
Histology | |
Squamous cell carcinoma | 59 (100) |
Différentiation | |
Well | 28 (47.5) |
Middle | 24 (40.7) |
Poor | 7 (11.9) |
Therapeutic sequence decided | |
Induction chemotherapy | 10 (17.0) |
Radiotherapy | 59 (100) |
Exclusive | 19 |
With Cetuximab | 25 |
With Cisplatine | 15 |
Variables 1 | Variables 1 | Absence of Residue N = 27 | Presence of Residue N = 19 | Univariate Analysis | Multivariate Analysis 2 | |
---|---|---|---|---|---|---|
p Value | OR [CI 95%] | p Value | ||||
Tumor diameter on MRI (mm) − Mean ± SD | 44.3 ± 18.8 | 52.6 ± 21.0 | 0.20 | |||
Median ADC tumor (s/mm2) − Mean ± SD | 0.79 ± 0.13 | 0.56 ± 0.11 | <0.0001 | |||
Patients with ADC tumor ≥0.7 | 24 (88.9) | 5 (26.3) | <0.0001 | 22.6 [4.9–103.6] | <0.0001 | |
<0.7 | 3 (11.1) | 14 (73.7) | ||||
Tumor location | Oral cavity | 2 (7.4) | 4 (21.0) | 0.23 | ||
Oropharynx | 16 (59.3) | 9 (47.4) | ||||
Larynx | 5 (18.5) | 1 (5.3) | ||||
Hypopharynx | 4 (14.8) | 2 (10.5) | ||||
Sinus | 0 (0.0) | 1 (5.3) | ||||
Cavum | 0 (0.0) | 1 (5.3) | ||||
Parotid | 0 (0.0) | 1 (5.3) | ||||
Initial T status | T1 | 2 (7.4) | 1 (5.3) | 0.64 | ||
T2 | 3 (11.1) | 1 (5.3) | ||||
T3 | 6 (22.2) | 2 (10.5) | ||||
T4 | 16 (59.3) | 15 (79.0) | ||||
Initial N status | N0 | 3 (11.1) | 6 (31.6) | 0.13 | ||
N+ | 24 (88.9) | 13 (68.4) | ||||
Initial M status | M0 | 27 (100.0) | 18 (94.7) | 0.41 | ||
M+ | 0 (0.0) | 1 (5.3) | ||||
Induction chemotherapy | Yes | 5 (18.5) | 3 (15.8) | 0.99 | ||
No | 22 (81.5) | 16 (84.2) | ||||
Therapeutic sequence | Radiotherapy exclusive | 6 (22.2) | 5 (26.3) | 0.18 | ||
Radiotherapy with Cetuximab | 10 (37.1) | 11 (57.9) | ||||
Radiotherapy with Cisplatine | 11 (40.7) | 3 (15.8) |
Variables | Variables 1 | Time of Disease-Free Survival (Days) 1 | Univariate Analysis p Value |
---|---|---|---|
Tumor diameter at first MRI (mm) Mean ± SD | 0.31 | ||
Delta ADC (ADC2–ADC1) Mean ± SD | 0.0009 | ||
Patients with Delta ADC (ADC2–ADC1) | ≥0.7 | 377.5 [286–402] | <0.0001 |
<0.7 | 253 [198–370] | ||
Induction chemotherapy | Yes | 343 [253–396] | 0.82 |
No | 353 [198–402] | ||
Therapeutic sequence | Radiotherapy exclusive | 336 [243–386] | 0.35 |
Radiotherapy with Cetuximab | 338 [198–396] | ||
Radiotherapy with Cisplatin | 370 [225–402] | ||
Tumor location | Oral cavity | 342.5 [315–370] | 0.71 |
Oropharynx | 346 [198–402] | ||
Larynx | 348 [243–391] | ||
Hypopharynx | 383 [343–394] | ||
Initial T status | T1 | 319.5 [253–386] | 0.69 |
T2 | 381 [280–389] | ||
T3 | 340.5 [243–391] | ||
T4 | 357 [198–402] | ||
Initial N status | N0 | 350 [198–402] | 0.28 |
N+ | 300 [243–357] | ||
Initial M status | M0 | 350.5 [198–402] | - |
M+ | - |
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Brenet, E.; Barbe, C.; Hoeffel, C.; Dubernard, X.; Merol, J.-C.; Fath, L.; Servagi-Vernat, S.; Labrousse, M. Predictive Value of Early Post-Treatment Diffusion-Weighted MRI for Recurrence or Tumor Progression of Head and Neck Squamous Cell Carcinoma Treated with Chemo-Radiotherapy. Cancers 2020, 12, 1234. https://doi.org/10.3390/cancers12051234
Brenet E, Barbe C, Hoeffel C, Dubernard X, Merol J-C, Fath L, Servagi-Vernat S, Labrousse M. Predictive Value of Early Post-Treatment Diffusion-Weighted MRI for Recurrence or Tumor Progression of Head and Neck Squamous Cell Carcinoma Treated with Chemo-Radiotherapy. Cancers. 2020; 12(5):1234. https://doi.org/10.3390/cancers12051234
Chicago/Turabian StyleBrenet, Esteban, Coralie Barbe, Christine Hoeffel, Xavier Dubernard, Jean-Claude Merol, Léa Fath, Stéphanie Servagi-Vernat, and Marc Labrousse. 2020. "Predictive Value of Early Post-Treatment Diffusion-Weighted MRI for Recurrence or Tumor Progression of Head and Neck Squamous Cell Carcinoma Treated with Chemo-Radiotherapy" Cancers 12, no. 5: 1234. https://doi.org/10.3390/cancers12051234