Top

Neuroradiology

Published in:

01-06-2006 | Head and Neck Radiology

Reliability of CT-based tumor volumetry after intraarterial chemotherapy in patients with small carcinoma of the oral cavity and the oropharynx

Authors: Stefan Rohde, Adorján F. Kovács, Joachim Berkefeld, Bernd Turowski

Published in: Neuroradiology | Issue 6/2006

Abstract

Introduction

The aim of the study was to evaluate the feasibility and consistency of CT-based tumor volumetry in patients with early carcinoma of the oral cavity and the oropharynx before and after intraarterial (IA) chemotherapy, comparing these data with clinical remission rates.

Methods

Included in the study were 61 patients (mean age 59.3 years; 47 men) with histologically proven small carcinoma of the oral cavity or the oropharynx (local tumor stages T1/2). Patients received IA chemotherapy with high-dose cisplatin as part of a multimodal therapeutic regimen and underwent both clinical and radiological examination before and 4 weeks after local chemotherapy.

Results

Clinical evaluation of tumor response was possible in all patients (61/61). Radiological assessment of tumor volume was feasible in 42 of 61 patients (69%), but failed in 19 (31%) due to the absence of deep tumoral spread, lack of contrast enhancement or severe dental artifacts. Patients in whom evaluation was possible according to volumetric and clinical criteria revealed comparable remission rates: overall response 54.8% versus 52.4%, stable disease 40.4% versus 47.6%, and tumor progression 4.8% versus 0.0%.

Conclusion

Because volume calculation was not feasible in approximately one-third of the patients, it cannot be recommended as a reliable indicator for treatment response in patients with small carcinoma of the oral cavity.

Claudio F, Cacace F, Comella G, et al (1990) Intraarterial chemotherapy through carotid transposition in advanced head and neck cancer. Cancer 65:1465–1471PubMedCrossRef

Simunek A, Krajina A, Hlava A (1993) Selective intraarterial chemotherapy of tumours in the lingual artery territory by a new approach. Cardiovasc Intervent Radiol 16:392–395PubMedCrossRef

Kovács AF, Turowski B, Ghahremani MT, Loitz M (1999) Intraarterial chemotherapy as neoadjuvant treatment of oral cancer. J Craniomaxillofac Surg 27:302–307PubMed

Robbins KT, Kumar P, Wong FS, et al (2000) Targeted chemoradiation for advanced head and neck cancer: analysis of 213 patients. Head Neck 22(7):687–693CrossRefPubMed

Robbins KT (2000) The evolving role of combined modality therapy in head and neck cancer. Arch Otolaryngol Head Neck Surg 126:265–269PubMed

Nakasato T, Katoh K, Sone M, et al (2000) Superselective continuous arterial infusion chemotherapy through the superficial temporal artery for oral cavity tumors. AJNR Am J Neuroradiol 21:1917–1922PubMed

Kovács AF, Schiemann M, Turowski B (2002) Combined modality treatment of oral and oropharyngeal cancer including neoadjuvant intraarterial cisplatin and radical surgery followed by current radiation and chemotherapy with weekly docetaxel – three year results of a pilot study. J Craniomaxillofac Surg 30:112–120PubMed

Kovács AF (2004) Intraarterial induction high-dose chemotherapy with cisplatin for oral and oropharyngeal cancer – long-term results. Br J Cancer 90:1323–1328CrossRefPubMed

Rohde S, Kovacs AF, Turowski B, Yan B, Zanella F, Berkefeld J (2005) Intra-arterial high-dose chemotherapy with cisplatin as part of a palliative treatment concept in oral cancer. AJNR Am J Neuroradiol 26(7):1804–1809PubMed

10.

Rohde S, Kovacs AF, Zanella FE, Berkefeld J, Turowski B (2005) Local chemotherapy for squamous cell cancer of the oral cavity and oropharynx. Radiologe 45:843–850CrossRefPubMed

11.

Hirai T, Korogi Y, Hamatake S, et al (1999) Stages III and IV squamous cell carcinoma of the mouth: three-year experience with superselective intraarterial chemotherapy using cisplatin prior to definitive treatment. Cardiovasc Intervent Radiol 22:201–205CrossRefPubMed

12.

Kovács AF, Grüterich G, Wagner M (2002) Long-term complete remission of oral cancer after anti-neoplastic chemotherapy as single treatment modality: role of local chemotherapy. J Chemother 14:95–101PubMed

13.

Kovács AF (2003) Intraarterial chemotherapy and chemoembolization in head and neck cancer. Establishment as a neoadjuvant routine method. Cancer Ther 1:1–9

14.

Jaulerry C, Rodriguez J, Brunin F, et al (1992) Induction chemotherapy in advanced head and neck tumors: results of two randomized trials. Int J Radiat Oncol Biol Phys 23:483–489PubMed

15.

Imai S, Kajihar Y, Munemori O, et al (1995) Superselective cisplatin (CDDP)-carboplatin (CBDCA) combined infusion for head and neck cancers. Eur J Radiol 21(2):94–99CrossRefPubMed

16.

Robbins KT, Kumar P, Regine WF, et al (1997) Efficacy of targeted supradose cisplatin and concomitant radiation therapy for advanced head and neck cancer: the Memphis experience. Int J Radiat Oncol Biol Phys 38:263–271CrossRefPubMed

17.

Kayahara H, Okuda M, Terakado N, Shintani S, Hamakawa H (2002) Non-randomized clinical study comparing chemotherapy plus radiotherapy with radiotherapy alone in neoadjuvant therapy for oral cancer. Gan To Kagaku Ryoho 29(6):911–916PubMed

18.

WHO (1979) Handbook for reporting results of cancer treatment (Offset Publication no. 48). World Health Organization, Geneva

19.

Sobin LH, Wittekind C (1997) UICC: TNM classification of malignant tumours. Wiley, New York

20.

Fisher BJ, Bauman GS, Leighton CE, Stitt L, Cairncross JG, Macdonald DR (1998) Low-grade gliomas in children: tumor volume response to radiation. J Neurosurg 88(6):969–974PubMedCrossRef

21.

Wapnir IL, Wartenberg DE, Greco RS (1996) Three dimensional staging of breast cancer. Breast Cancer Res Treat 41:15–19CrossRefPubMed

22.

Gebel JM, Sila CA, Sloan MA, et al (1998) Comparison of the ABC/2 estimation technique to computer-assisted volumetric analysis of intraparenchymal and subdural hematomas complicating the GUSTO-1 trial. Stroke 29:1799–1801PubMed

23.

Van Hoe L, Haven F, Bellon E, et al (1997) Factors influencing the accuracy of volume measurements in spiral CT: a phantom study. J Comput Assist Tomogr 21(2):332–338CrossRefPubMed

24.

Disler D, Marr D, Rosenthal D (1994) Accuracy of volume measurements of computed tomography and magnetic resonance imaging phantoms by three-dimensional reconstruction and preliminary clinical application. Invest Radiol 29:739–745PubMedCrossRef

25.

Therasse P, Arbuck SG, Eisenhauer EA, et al (2000) New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 92:205–216CrossRefPubMed

26.

Futurani K, Fuwa N, Kodaira T, et al (2002) Continuous selective intraarterial chemotherapy in combination with irradiation for locally advanced cancer for the tongue and tongue base. Oral Oncol 38(2):145–152CrossRefPubMed

27.

Denis F, Garaud P, Bardet E, et al (2004) Final results of the 94-01 French head and neck oncology and radiotherapy group randomized trial comparing radiotherapy alone with concomitant radiochemotherapy in advanced-stage oropharynx carcinoma. J Clin Oncol 22(1):69–76CrossRefPubMed

28.

Cavalcanti MG, Vannier MW (2000) Measurement of the volume of oral tumors by three-dimensional spiral computed tomography. Dentomaxillofac Radiol 29(1):35–40CrossRefPubMed

29.

Chong VF, Zhou JY, Khoo JB, Huang J, Lim TK (2004) Tongue carcinoma: tumor volume measurement. Int J Radiat Oncol Biol Phys 59(1):59–66CrossRefPubMed

30.

Van den Broek GB, Rasch CRN, Pameijer FA, et al (2004) Pretreatment probability model for predicting outcome after intraarterial chemoradiation for advanced head and neck carcinoma. Cancer 101(8):1809–1817CrossRefPubMed

31.

Tuncbilek N, Karakas HM, Okten OO (2005) Dynamic contrast enhanced MRI in the differential diagnosis of soft tissue tumors. Eur J Radiol 53(3):500–505CrossRefPubMed

32.

Furman-Haran E, Schechtman E, Kelcz F, Kirshenbaum K, Degani H (2005) Magnetic resonance imaging reveals functional diversity of the vasculature in benign and malignant breast lesions. Cancer 104(4):708–718CrossRefPubMed

33.

Shah GV, Gandhi D, Mukherji SK (2004) Magnetic resonance spectroscopy of head and neck neoplasms. Top Magn Reson Imaging 15(2):87–94CrossRefPubMed

34.

Adalsteinsson E, Spielman DM, Pauly JM, Terris DJ, Sommer G, Macovski A (1998) Feasibility study of lactate imaging of head and neck tumors. NMR Biomed 11(7):360–369CrossRefPubMed

Title: Reliability of CT-based tumor volumetry after intraarterial chemotherapy in patients with small carcinoma of the oral cavity and the oropharynx
Authors: Stefan Rohde
Adorján F. Kovács
Joachim Berkefeld
Bernd Turowski
Publication date: 01-06-2006
Publisher: Springer-Verlag
Published in: Neuroradiology / Issue 6/2006
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-006-0072-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Reliability of CT-based tumor volumetry after intraarterial chemotherapy in patients with small carcinoma of the oral cavity and the oropharynx

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 6/2006

Serial MRI of limbic encephalitis

Self-expanding stent-assisted middle cerebral artery recanalization: technical note

Silent microemboli related to diagnostic cerebral angiography: a matter of operator’s experience and patient’s disease

Magnetic versus manual guidewire manipulation in neuroradiology: in vitro results

European Society of Neuroradiology (ESNR)

Intracranial angioplasty and stenting for cerebral atherosclerosis: new treatments for stroke are needed!