Tumor plasma flow determined by dynamic contrast-enhanced MRI predicts response to induction chemotherapy in head and neck cancer

Jonathan M Bernstein; Lucy E Kershaw; Stephanie B Withey; Natalie M Lowe; Jarrod J Homer; Nicholas J Slevin; Suzanne C Bonington; Bernadette M Carrington; Catharine M West

doi:10.1016/j.oraloncology.2015.01.013

Tumor plasma flow determined by dynamic contrast-enhanced MRI predicts response to induction chemotherapy in head and neck cancer

Jonathan M Bernstein, Lucy E Kershaw, Stephanie B Withey, Natalie M Lowe, Jarrod J Homer, Nicholas J Slevin, Suzanne C Bonington, Bernadette M Carrington, Catharine M West

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVES: Non-response to induction chemotherapy (IC) occurs in 30% of head and neck squamous cell carcinoma (HNSCC) and has been predicted by tumor plasma flow (Fp) derived by perfusion computed tomography. The present study was designed to test whether baseline tumor Fp determined by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) would predict IC response.

MATERIALS AND METHODS: A prospective open study powered to test the relationship between tumor Fp and response to IC (docetaxel, cisplatin, 5-fluorouracil) enrolled 50 patients with stage IV HNSCC. Response after two IC cycles was measured by MRI using Response Evaluation Criteria in Solid Tumors in 37 patients. Tumor Fp (primary end point) and multiple parameters in tumors and lymph nodes (secondary end points) were generated at baseline. Differences in baseline DCE-MRI parameters according to IC response were assessed by the Mann-Whitney U test, and predictive value by receiver operating characteristic (ROC) analysis.

RESULTS: Median baseline tumor Fp was 53.2ml/100ml/min in 25 responders and 23.9 in 12 non-responders (U 82; P=0.027; area under ROC curve (AUC) 0.73). Median baseline Fp in lymph nodes was 25.8ml/100ml/min for 37 nodes in 25 responders and 17.1 for 15 nodes in 12 non-responders (U 186, P=0.066; AUC 0.67). Frequency of IC response in 37 patients was 68% overall, 83% for tumor Fp above the median (40.6ml/100ml/min) and 45% below the median. Other DCE-MRI parameters were not associated with IC response.

CONCLUSION: Pre-treatment tumor Fp determined by DCE-MRI predicts IC response in HNSCC.

Original language	English
Pages (from-to)	508-13
Number of pages	6
Journal	Oral Oncology
Volume	51
Issue number	5
DOIs	https://doi.org/10.1016/j.oraloncology.2015.01.013
Publication status	Published - May 2015

Keywords

Adult
Carcinoma, Squamous Cell
Contrast Media
Female
Head and Neck Neoplasms
Humans
Magnetic Resonance Imaging
Male
Middle Aged

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.oraloncology.2015.01.013

Cite this

@article{0feba8763b2741f292647d0342837fe3,

title = "Tumor plasma flow determined by dynamic contrast-enhanced MRI predicts response to induction chemotherapy in head and neck cancer",

abstract = "OBJECTIVES: Non-response to induction chemotherapy (IC) occurs in 30% of head and neck squamous cell carcinoma (HNSCC) and has been predicted by tumor plasma flow (Fp) derived by perfusion computed tomography. The present study was designed to test whether baseline tumor Fp determined by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) would predict IC response.MATERIALS AND METHODS: A prospective open study powered to test the relationship between tumor Fp and response to IC (docetaxel, cisplatin, 5-fluorouracil) enrolled 50 patients with stage IV HNSCC. Response after two IC cycles was measured by MRI using Response Evaluation Criteria in Solid Tumors in 37 patients. Tumor Fp (primary end point) and multiple parameters in tumors and lymph nodes (secondary end points) were generated at baseline. Differences in baseline DCE-MRI parameters according to IC response were assessed by the Mann-Whitney U test, and predictive value by receiver operating characteristic (ROC) analysis.RESULTS: Median baseline tumor Fp was 53.2ml/100ml/min in 25 responders and 23.9 in 12 non-responders (U 82; P=0.027; area under ROC curve (AUC) 0.73). Median baseline Fp in lymph nodes was 25.8ml/100ml/min for 37 nodes in 25 responders and 17.1 for 15 nodes in 12 non-responders (U 186, P=0.066; AUC 0.67). Frequency of IC response in 37 patients was 68% overall, 83% for tumor Fp above the median (40.6ml/100ml/min) and 45% below the median. Other DCE-MRI parameters were not associated with IC response.CONCLUSION: Pre-treatment tumor Fp determined by DCE-MRI predicts IC response in HNSCC.",

keywords = "Adult, Carcinoma, Squamous Cell, Contrast Media, Female, Head and Neck Neoplasms, Humans, Magnetic Resonance Imaging, Male, Middle Aged",

author = "Bernstein, {Jonathan M} and Kershaw, {Lucy E} and Withey, {Stephanie B} and Lowe, {Natalie M} and Homer, {Jarrod J} and Slevin, {Nicholas J} and Bonington, {Suzanne C} and Carrington, {Bernadette M} and West, {Catharine M}",

year = "2015",

month = may,

doi = "10.1016/j.oraloncology.2015.01.013",

language = "English",

volume = "51",

pages = "508--13",

journal = "Oral Oncology",

issn = "1368-8375",

publisher = "Elsevier BV",

number = "5",

}

TY - JOUR

T1 - Tumor plasma flow determined by dynamic contrast-enhanced MRI predicts response to induction chemotherapy in head and neck cancer

AU - Bernstein, Jonathan M

AU - Kershaw, Lucy E

AU - Withey, Stephanie B

AU - Lowe, Natalie M

AU - Homer, Jarrod J

AU - Slevin, Nicholas J

AU - Bonington, Suzanne C

AU - Carrington, Bernadette M

AU - West, Catharine M

PY - 2015/5

Y1 - 2015/5

N2 - OBJECTIVES: Non-response to induction chemotherapy (IC) occurs in 30% of head and neck squamous cell carcinoma (HNSCC) and has been predicted by tumor plasma flow (Fp) derived by perfusion computed tomography. The present study was designed to test whether baseline tumor Fp determined by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) would predict IC response.MATERIALS AND METHODS: A prospective open study powered to test the relationship between tumor Fp and response to IC (docetaxel, cisplatin, 5-fluorouracil) enrolled 50 patients with stage IV HNSCC. Response after two IC cycles was measured by MRI using Response Evaluation Criteria in Solid Tumors in 37 patients. Tumor Fp (primary end point) and multiple parameters in tumors and lymph nodes (secondary end points) were generated at baseline. Differences in baseline DCE-MRI parameters according to IC response were assessed by the Mann-Whitney U test, and predictive value by receiver operating characteristic (ROC) analysis.RESULTS: Median baseline tumor Fp was 53.2ml/100ml/min in 25 responders and 23.9 in 12 non-responders (U 82; P=0.027; area under ROC curve (AUC) 0.73). Median baseline Fp in lymph nodes was 25.8ml/100ml/min for 37 nodes in 25 responders and 17.1 for 15 nodes in 12 non-responders (U 186, P=0.066; AUC 0.67). Frequency of IC response in 37 patients was 68% overall, 83% for tumor Fp above the median (40.6ml/100ml/min) and 45% below the median. Other DCE-MRI parameters were not associated with IC response.CONCLUSION: Pre-treatment tumor Fp determined by DCE-MRI predicts IC response in HNSCC.

AB - OBJECTIVES: Non-response to induction chemotherapy (IC) occurs in 30% of head and neck squamous cell carcinoma (HNSCC) and has been predicted by tumor plasma flow (Fp) derived by perfusion computed tomography. The present study was designed to test whether baseline tumor Fp determined by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) would predict IC response.MATERIALS AND METHODS: A prospective open study powered to test the relationship between tumor Fp and response to IC (docetaxel, cisplatin, 5-fluorouracil) enrolled 50 patients with stage IV HNSCC. Response after two IC cycles was measured by MRI using Response Evaluation Criteria in Solid Tumors in 37 patients. Tumor Fp (primary end point) and multiple parameters in tumors and lymph nodes (secondary end points) were generated at baseline. Differences in baseline DCE-MRI parameters according to IC response were assessed by the Mann-Whitney U test, and predictive value by receiver operating characteristic (ROC) analysis.RESULTS: Median baseline tumor Fp was 53.2ml/100ml/min in 25 responders and 23.9 in 12 non-responders (U 82; P=0.027; area under ROC curve (AUC) 0.73). Median baseline Fp in lymph nodes was 25.8ml/100ml/min for 37 nodes in 25 responders and 17.1 for 15 nodes in 12 non-responders (U 186, P=0.066; AUC 0.67). Frequency of IC response in 37 patients was 68% overall, 83% for tumor Fp above the median (40.6ml/100ml/min) and 45% below the median. Other DCE-MRI parameters were not associated with IC response.CONCLUSION: Pre-treatment tumor Fp determined by DCE-MRI predicts IC response in HNSCC.

KW - Adult

KW - Carcinoma, Squamous Cell

KW - Contrast Media

KW - Female

KW - Head and Neck Neoplasms

KW - Humans

KW - Magnetic Resonance Imaging

KW - Male

KW - Middle Aged

U2 - 10.1016/j.oraloncology.2015.01.013

DO - 10.1016/j.oraloncology.2015.01.013

M3 - Article

C2 - 25700703

SN - 1368-8375

VL - 51

SP - 508

EP - 513

JO - Oral Oncology

JF - Oral Oncology

IS - 5

ER -

Tumor plasma flow determined by dynamic contrast-enhanced MRI predicts response to induction chemotherapy in head and neck cancer

Abstract

Keywords

UN SDGs

Access to Document

Fingerprint

Cite this