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Open Access 01-02-2020 | Radiotherapy | Oncology

Pretreatment ADC is not a prognostic factor for local recurrences in head and neck squamous cell carcinoma when clinical T-stage is known

Authors: Boris Peltenburg, Juliette P. Driessen, Jeanine E. Vasmel, Frank A. Pameijer, Luuk M. Janssen, Chris H. J. Terhaard, Remco de Bree, Marielle E. P. Philippens

Published in: European Radiology | Issue 2/2020

Abstract

Objectives

Pretreatment identification of radio-insensitive head and neck squamous cell carcinomas (HNSCC) would affect treatment modality selection. The apparent diffusion coefficient (ADC) of a tumor could be a predictor of local recurrence. However, little is known about its prognostic value next to known factors such as clinical T-stage. The aim of the present study is to determine the added value of pretreatment ADC to clinical T-stage as a prognostic factor for local recurrence.

Methods

This retrospective cohort study included 217 patients with HNSCC treated with (chemo)radiotherapy between April 2009 and December 2015. All patients underwent diffusion-weighted MRI prior to treatment. Median ADC values of all tumors were obtained using a semi-automatic delineation method. Univariate models containing ADC and T-stage were compared with a multivariable model containing both variables.

Results

Fifty-eight patients experienced a local recurrence within 3 years. On average, the ADC value in the group of patients with a recurrence was 1.01 versus 1.00 (10⁻³ mm²/s) in the group without a recurrence. Univariate analysis showed no significant association between tumor ADC and local recurrence within 3 years after (chemo)radiotherapy (p = 0.09). Cox regression showed that clinical T-stage was an independent predictor of local recurrence and adding ADC to the model did not increase its performance.

Conclusion

Pretreatment ADC has no added value as a prognostic factor for local recurrence to clinical T-stage.

Key Points

• Pretreatment identification of head and neck squamous cell carcinoma patients who do not benefit from (chemo)radiotherapy could improve personalized cancer care.

• The apparent diffusion coefficient (ADC) obtained from diffusion-weighted MRI has been reported to be a prognostic factor for local recurrence.

• In this study, ADC has no added value as a prognostic factor compared with clinical T-stage.

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Title: Pretreatment ADC is not a prognostic factor for local recurrences in head and neck squamous cell carcinoma when clinical T-stage is known
Authors: Boris Peltenburg
Juliette P. Driessen
Jeanine E. Vasmel
Frank A. Pameijer
Luuk M. Janssen
Chris H. J. Terhaard
Remco de Bree
Marielle E. P. Philippens
Publication date: 01-02-2020
Publisher: Springer Berlin Heidelberg
Keywords: Radiotherapy
Cytostatic Therapy
Published in: European Radiology / Issue 2/2020
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-019-06426-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Pretreatment ADC is not a prognostic factor for local recurrences in head and neck squamous cell carcinoma when clinical T-stage is known

Abstract

Objectives

Methods

Results

Conclusion

Key Points

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Key Points

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