CT-based follow-up following radiotherapy or radiochemotherapy for locally advanced head and neck cancer; outcome and development of a prognostic model for regional control.

CT-based follow-up following radiotherapy or radiochemotherapy for locally advanced head and neck cancer; outcome and development of a prognostic model for regional control.

Br J Radiol. 2016 Oct 6;:20160492

Authors: Nevens D, Vantomme O, Laenen A, Hermans R, Nuyts S

Abstract
OBJECTIVES: The purpose of this study is to make a prognostic model for regional relapse in head and neck cancer using clinical and Computed Tomography (CT) parameters.
METHODS: 183 patients with lymph node-positive head and neck cancer were treated between 2002 and 2012 with radiotherapy or concurrent chemoradiotherapy. CT studies pre- and post-treatment were reviewed for lymph node size and presence of necrosis, extracapsular spread and calcifications. For every patient, correlations with 3 year regional control (RC), metastasis free survival (MFS), disease free survival (DFS) and overall survival (OS) were made.
RESULTS: 3-year outcome rates were as follows: LC of 84%, RC of 80%, MFS of 74%, DFS of 61%, OS of 63%. Pre-treatment nodal size and presence of necrosis were associated with a poorer outcome. This was also the case for post-treatment lymph node size, the presence of necrosis and extracapsular spread. We developed a CT-based prognostic model for regional control with an area under the curve of 0.78 (95% Confidence Interval 0.63;0.85).
CONCLUSIONS: We reached a good outcome in our patient cohort using a CT-based follow-up approach. A CT-based model was developed which can aid in predicting regional control. Advances in knowledge: A prognostic model is proposed which can aid to predict regional control and the necessity of post-radiotherapy neck dissection using clinical parameters and parameters derived from the post-treatment CT study. This is the first paper to propose a prognostic model for regional relapse in head and neck cancer based on these parameters.

PMID: 27710014 [PubMed - as supplied by publisher]

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