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Value of Computed Tomography‐Based Tumor Volume as a Predictor of Outcomes in Hypopharyngeal Cancer After Treatment With Definitive Radiotherapy
Author(s) -
Chen ShangWen,
Yang ShihNeng,
Liang JiAn,
Tsai MingHsiu,
Shiau AnCheng,
Lin FangJen
Publication year - 2006
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/01.mlg.0000237804.38761.81
Subject(s) - medicine , hypopharyngeal cancer , pyriform sinus , radiation therapy , larynx , multivariate analysis , cancer , nuclear medicine , computed tomography , primary tumor , retrospective cohort study , radiology , surgery , metastasis , fistula
Objectives: To investigate the value of pretreatment computed tomography (CT) volumetric analysis for the prediction of treatment outcome in patients with hypopharyngeal cancer (HPC) treated by definitive radiotherapy (RT). Methods: From January 2000 through February 2004, 63 patients with HPC were enrolled for a retrospective analysis. The pyriform sinus was the principle site of involvement in 62 cases. All patients received with 1.8 Gy daily to a total dose of 68.4 to 73.8 Gy (median, 70.2 Gy). Contrast‐enhanced CT images were transferred to a planning system. Tumor volume measurement was derived from summation of the primary and metastatic nodal tumor. Results: With a median follow‐up of 38 (range, 24–68) months, the 5 year local relapse‐free survival (LRFS) was 83% for patients with T1 to T2 disease, 46% for those with T3 disease, and 40% for those with T4 disease ( P = .01). The 5 year LRFS was 75% for those with tumors less than 40 mL and 26% when volumes were 40 mL of larger ( P = .0001). For patients with T3 to T4 disease, the 5 year LRFS was 70% for those with tumors less than 40 mL and 24% when volumes were 40 mL or larger ( P = .0005). Multivariate analyses of local relapse‐free survival revealed two prognostic factors: tumor volume more than 40 mL and the involvement of the larynx. Conclusions: CT‐based tumor volumes are a strong predictor of outcomes for HPC treated using definitive RT. A selected group of patients, mainly those with tumor volumes less than 40 mL, should be considered for laryngeal preservation.