End of treatment cone-beam computed tomography (CBCT) is predictive of radiation response and overall survival in oropharyngeal squamous cell carcinoma

Radiation Oncology

Whitney Sumner¹  Kevin Moore¹  Lucas Vitzthum¹  Sayuri Miyauchi¹  Todd Atwood¹  Andrew B. Sharabi²  James Murphy²  Loren K. Mell²  Arno J. Mundt²  Joseph A. Califano³  Sangwoo S. Kim⁴ 

[1] Department of Radiation Medicine and Applied Sciences, San Diego Moores Cancer Center, University of California, 3855 Health Sciences Drive, MC 0843, 92093, La Jolla, CA, USA;Department of Radiation Medicine and Applied Sciences, San Diego Moores Cancer Center, University of California, 3855 Health Sciences Drive, MC 0843, 92093, La Jolla, CA, USA;Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA;Department of Radiation Medicine and Applied Sciences, San Diego Moores Cancer Center, University of California, 3855 Health Sciences Drive, MC 0843, 92093, La Jolla, CA, USA;Moores Cancer Center, University of California, San Diego, La Jolla, CA, USA;Department of Surgery, Division of Otolaryngology, University of California, San Diego, La Jolla, CA, USA;School of Medicine, University of California, San Diego, La Jolla, CA, USA;

关键词: Head and neck squamous cell carcinoma;    Head and neck cancer;    Radiotherapy;    Radiation;    Cone beam CT;    CBCT;   

DOI  :  10.1186/s13014-021-01871-w

来源: Springer

【 摘 要 】

BackgroundImage guidance in radiation oncology has resulted in significant improvements in the accuracy and precision of radiation therapy (RT). Recently, the resolution and quality of cone beam computed tomography (CBCT) for image guidance has increased so that tumor masses and lymph nodes are readily detectable and measurable. During treatment of head and neck squamous cell carcinoma (HNSCC), on-board CBCT setup imaging is routinely obtained; however, this CBCT imaging data is not utilized to predict patient outcomes. Here, we analyzed whether changes in CBCT measurements obtained during a course of radiation therapy correlate with responses on routine 3-month follow-up diagnostic imaging and overall survival (OS).Materials/methodsPatients with oropharyngeal primary tumors who received radiation therapy between 2015 and 2018 were included. Anatomical measurements were collected of largest nodal conglomerate (LNC) at CT simulation, end of radiation treatment (EOT CBCT), and routine 3-month post-RT imaging. At each timepoint anteroposterior (AP), mediolateral (ML) and craniocaudal (CC) measurements were obtained and used to create a 2-dimensional (2D) maximum.ResultsCBCT data from 64 node positive patients were analyzed. The largest nodal 2D maximum and CC measurements on EOT CBCT showed a statistically significant correlation with complete response on 3-month post-RT imaging (r = 0.313, p = 0.02 and r = 0.318, p = 0.02, respectively). Furthermore, patients who experienced a 30% or greater reduction in the CC dimension had improved OS (Binary Chi-Square HR 4.85, p = 0.028).ConclusionDecreased size of pathologic lymph nodes measured using CBCT setup imaging during a radiation course correlates with long term therapeutic response and overall survival of HNSCC patients. These results indicate that CBCT setup imaging may have utility as an early predictor of treatment response in oropharyngeal HNSCC.

【 授权许可】

CC BY