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Changes in functional imaging parameters following induction chemotherapy have important implications for individualised patient-based treatment regimens for advanced head and neck cancer.

Authors :
Powell C
Schmidt M
Borri M
Koh DM
Partridge M
Riddell A
Cook G
Bhide SA
Nutting CM
Harrington KJ
Newbold KL
Source :
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2013 Jan; Vol. 106 (1), pp. 112-7. Date of Electronic Publication: 2012 Oct 22.
Publication Year :
2013

Abstract

Background: When induction chemotherapy (IC) is used prior to chemoradiotherapy (CRT) in head and neck cancer (HNC), functional imaging (FI) may inform adaptation of treatment plans with the aim of optimising outcomes. Understanding the impact of IC on FI parameters is, therefore, essential.<br />Purpose: To prospectively evaluate the feasibility of acquiring serial FI ((18)F-FDG-PET, diffusion-weighted (DW) and dynamic contrast-enhanced (DCE) MRI) and its role in defining individualised treatment regimens following IC in HNC.<br />Methods and Materials: Ten patients with stage III and IV HNC underwent conventional (CT and MRI) and functional (DW, DCE-MRI and (18)F-FDG-PET/CT) imaging at baseline and following two cycles of IC prior to definitive CRT.<br />Results: One patient withdrew due to claustrophobia. Seven out of nine patients had a complete metabolic response to IC on (18)F-FDG-PET imaging. DCE-MRI showed a significant fall in transfer constant (K(trans)) (0.209 vs 0.129 min(-1)P<0.01) and integrated area under gadolinium curve at 60s (IAUGC6O) (18.4 vs 11.9 mmol/min, P<0.01) and DW-MRI a rise in ADC (0.89 vs 1.06 × 10(-3) mm(2)/s, P<0.01) following IC.<br />Conclusions: Acquiring FI sequences is feasible in HNC. There are marked changes in FI parameters following IC which may guide adaptation of individualised treatment regimens.<br /> (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

Details

Language :
English
ISSN :
1879-0887
Volume :
106
Issue :
1
Database :
MEDLINE
Journal :
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
Publication Type :
Academic Journal
Accession number :
23089306
Full Text :
https://doi.org/10.1016/j.radonc.2012.09.009