Sotirios Bisdas MD, Presenter: Nothing to Disclose

Gordana Glavina MD, Abstract Co-Author: Nothing to Disclose

Thomas Josef Vogl MD, Abstract Co-Author: Nothing to Disclose

Zoran Rumboldt MD, Abstract Co-Author: Research grant, Bracco Group Consultant, Bracco Group

To assess whether baseline perfusion CT (PCT) and tumor volume predict outcome in chemoradiated patients with oral cavity, oropharynx, and hypopharynx squamous cell carcinoma (SCCA) after surgical excision.

Twenty-one patients with SCCA were examined (PCT with routine neck CT) before surgery and adjuvant chemoradiotherapy. PET/CT was performed for follow-up. Pearson correlation coefficients were used and a regression model, including survival curves, was constructed to predict disease free survival, recurrence, and distant metastasis based on age, gender, tumor (T) and nodal (N) stage, tumor volume and PCT parameters.

T stage, tumor volume, N stage, maximum blood flow  and blood volume (BFmax, BVmax), mean transit time (MTT), and radiation dose were independent predictors for recurrence (p<0.001). Independent predictors for distant metastasis were T stage, N stage and tumor volume (p≤0.02), permeability (PS), maximum PS (PSmax), MTT (p≤0.001), BV (p=0.004), and BVmax (p=0.04). The average (SD) disease free survival was 20.0(±11.7) months [independent predictors: T stage and tumor volume (p≤0.04), N stage (p=0.03), BV (p=0.012), MTT (p<0.001), PS (p=0.001), PSmax (p=0.003)]. Survival curves revealed significant differences in tumor volume (p=0.002, Hazard Ratio (HR) 0.6, 95% CI: 0.2-0.7), PS (p=0.0006, HR 1.6, 95% CI: 1.3-2.9), and PSmax (p<0.0001, HR 3.1, 95% CI: 4.2-23.1).

PCT parameters, together with tumor volume, have a predictive role of the outcome in patients with SCCA treated with adjuvant radiochemotherapy after definitive surgery.

Patients with SCCA treated with surgery and adjuvant chemoradiation may benefit from a baseline perfusion CT for  predicting the therapeutic outcome and individually tailor the therapy regimen.

Bisdas, S, Glavina, G, Vogl, T, Rumboldt, Z, Baseline Perfusion CT Predicts Adjuvant Chemoradiation Outcome after Surgery in SCCA of the Upper Aerodigestive Tract.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6012441.html