title: Evaluation of pretreatment computed tomography as a predictor of local control in T1/T2 pyriform sinus carcinoma treated with definitive radiotherapy.
abstract: BACKGROUND
  This study was undertaken to determine whether pretreatment computed tomography (CT) findings can predict local control in pyriform sinus carcinoma treated with definitive radiotherapy (RT).
  
  
  METHODS
  Twenty-three patients with pyriform sinus carcinoma (T1: n = 5; T2: n = 18) were treated with high-dose RT and followed for a minimum of 2 years. Tumor volumes and extent were determined on pretreatment CT studies. The specific CT parameters assessed were analyzed as predictors of local control.
  
  
  RESULTS
  There was a significant decrease in local control rate for tumors over 6.5 mL (1 of 4 [25%]) relative to tumors under 6.5 mL (17 of 19 [89%]; p = .021). Sensitivity and specificity for local control using this cutoff were 94% and 60%, respectively. Tumor score, as a measure of anatomic extent, was also found to be a significant predictor of local control (p = .033). The local control rate was not influenced significantly by the presence of "minimal" apex disease (< 10 mm in greatest dimensions as measured on CT) but decreased significantly when "bulk" apex disease (> OR = 10 mm) was present (p = .027). Laryngeal cartilage sclerosis was not a significant predictor of outcome.
  
  
  CONCLUSIONS
  Computed tomography can stratify pyriform sinus carcinomas into groups more or less likely to be locally controlled with definitive RT.
authors.affiliation: Department of Radiology, University of Florida College of Medicine/Shands Hospital, Gainesville 32610, USA.
authors.forename: F A
authors.initials: FA
authors.lastname: Pameijer
authors.forename: A A
authors.initials: AA
authors.lastname: Mancuso
authors.forename: W M
authors.initials: WM
authors.lastname: Mendenhall
authors.forename: J T
authors.initials: JT
authors.lastname: Parsons
authors.forename: S K
authors.initials: SK
authors.lastname: Mukherji
authors.forename: R
authors.initials: R
authors.lastname: Hermans
authors.forename: P S
authors.initials: PS
authors.lastname: Kubilis
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D005069:Evaluation Studies as Topic; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D007817:Laryngeal Cartilages / Q000000981:diagnostic imaging / Q000473:pathology; D007822:Laryngeal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D016015:Logistic Models; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009367:Neoplasm Staging; D010610:Pharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D011300:Preoperative Care; D011879:Radiotherapy Dosage; D012074:Remission Induction; D012598:Sclerosis; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed