Jonathan M Bernstein1, Lucy E Kershaw2, Stephanie B Withey2, Natalie M Lowe3, Jarrod J Homer4, Nicholas J Slevin3, Suzanne C Bonington5, Bernadette M Carrington5, Catharine M West3. 1. University Department of Otolaryngology - Head & Neck Surgery, Manchester Academic Health Science Centre, University of Manchester, Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Oxford Road, Manchester M13 9WL, UK; Translational Radiobiology Group, Institute of Cancer Sciences, Manchester Academic Health Science Centre, University of Manchester, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK. Electronic address: jonathan.bernstein@doctors.org.uk. 2. Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK. 3. Translational Radiobiology Group, Institute of Cancer Sciences, Manchester Academic Health Science Centre, University of Manchester, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK. 4. University Department of Otolaryngology - Head & Neck Surgery, Manchester Academic Health Science Centre, University of Manchester, Manchester Royal Infirmary, Central Manchester University Hospitals NHS Foundation Trust, Oxford Road, Manchester M13 9WL, UK; Translational Radiobiology Group, Institute of Cancer Sciences, Manchester Academic Health Science Centre, University of Manchester, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK. 5. Department of Radiology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester M20 4BX, UK.
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.
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.
Authors: S Chawla; L A Loevner; S G Kim; W-T Hwang; S Wang; G Verma; S Mohan; V LiVolsi; H Quon; H Poptani Journal: AJNR Am J Neuroradiol Date: 2017-11-16 Impact factor: 3.825
Authors: Natalie M Lowe; Jonathan M Bernstein; Kathleen Mais; Kate Garcez; Lip W Lee; Andrew Sykes; David J Thomson; Jarrod J Homer; Catharine M West; Nicholas J Slevin Journal: J Cancer Res Clin Oncol Date: 2017-12-08 Impact factor: 4.553
Authors: Natalie M Lowe; Lucy E Kershaw; Jonathan M Bernstein; Stephanie B Withey; Kathleen Mais; Jarrod J Homer; Nicholas J Slevin; Suzanne C Bonington; Bernadette M Carrington; Catharine M West Journal: PLoS One Date: 2018-03-28 Impact factor: 3.240
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Authors: Yue Cao; Madhava Aryal; Pin Li; Choonik Lee; Matthew Schipper; Peter G Hawkins; Christina Chapman; Dawn Owen; Aleksandar F Dragovic; Paul Swiecicki; Keith Casper; Francis Worden; Theodore S Lawrence; Avraham Eisbruch; Michelle Mierzwa Journal: Front Oncol Date: 2019-11-14 Impact factor: 6.244