Work

Prognostic value of pretreatment radiological MRI variables and dynamic contrast-enhanced MRI on radiotherapy treatment outcome in laryngeal and hypopharyngeal tumors

Year: 2024

Type: article

Abstract: Background This study aimed to determine the prognostic value of radiological magnetic resonance imaging (MRI) variables and dynamic contrast enhanced (DCE)-MRI for local control (LC), disease control (DC), and overall survival (OS) in laryngeal and hypopharyngeal cancer patients after radiotherapy. Methods 320 patients treated with radiotherapy were retrospectively included. Pretreatment MRIs were evaluated for the following anatomical tumor characteristics: cartilage invasion, extralaryngeal spread, and involvement of the anterior commissure, pre-epiglottic space, and paralaryngeal space. Pretreatment DCE-MRI was available in 89 patients. The median and 95th percentile of the 60-second area under the contrast-distribution-curve (AUC60 median and AUC60 p95 ) were determined in the tumor volume. Results Univariable log-rank test determined that extralaryngeal spread, tumor volume and T-stage were prognostic for worse LC, DC, and OS. A low AUC60 p95 (<31.7 mmol·s/L) and thyroid cartilage invasion were prognostic for worse OS. In multivariable analysis, a Cox proportional hazard model showed that a AUC60 p95 ≥ 31.7 mmol·s/L was prognostic for better OS (HR=0.25, P <.001). Tumor volume was prognostic for DC (HR=3.42, P <.001) and OS (HR=3.27, P <.001). No anatomical MRI variables were significantly prognostic for LC, DC, or OS in multivariable analysis when corrected for confounders. Conclusion Low pretreatment AUC60 p95 is prognostic for a worse OS, suggesting that poor tumor perfusion leads to worse survival. Large tumor volume is also prognostic for worse DC and OS. Anatomical MRI parameters are not prognostic for any of the evaluated treatment outcomes when corrected for confounders like age, T-stage, N-stage, and tumor volume.

Source: Clinical and Translational Radiation Oncology

DOI: 10.1016/j.ctro.2024.100857

Authors: Hilde J.G. Smits, Saskia J. Vink, Mischa de Ridder, Marielle E.P. Philippens, Jan W. Dankbaar

Institution: University Medical Center Utrecht

Language: English

Topic: Head and Neck Cancer Studies

Subfield: Otorhinolaryngology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,130