Reliability of CT-based tumor volumetry after intraarterial chemotherapy in patients with small carcinoma of the oral cavity and the oropharynx.
BACKGROUND
The aim of the study was to evaluate the feasibility and consistency of CT-based tumor volumetry in patients with early carcinoma of the oral cavity and the oropharynx before and after intraarterial (IA) chemotherapy, comparing these data with clinical remission rates.


METHODS
Included in the study were 61 patients (mean age 59.3 years; 47 men) with histologically proven small carcinoma of the oral cavity or the oropharynx (local tumor stages T1/2). Patients received IA chemotherapy with high-dose cisplatin as part of a multimodal therapeutic regimen and underwent both clinical and radiological examination before and 4 weeks after local chemotherapy.


RESULTS
Clinical evaluation of tumor response was possible in all patients (61/61). Radiological assessment of tumor volume was feasible in 42 of 61 patients (69%), but failed in 19 (31%) due to the absence of deep tumoral spread, lack of contrast enhancement or severe dental artifacts. Patients in whom evaluation was possible according to volumetric and clinical criteria revealed comparable remission rates: overall response 54.8% versus 52.4%, stable disease 40.4% versus 47.6%, and tumor progression 4.8% versus 0.0%.


CONCLUSIONS
Because volume calculation was not feasible in approximately one-third of the patients, it cannot be recommended as a reliable indicator for treatment response in patients with small carcinoma of the oral cavity.
Rohde
Stefan
S
Department of Neuroradiology, Ruprecht Karls-University Medical School, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. stefan.rohde@med.uni-heidelberg.de
Kovács
Adorján F
AF
Berkefeld
Joachim
J
Turowski
Bernd
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D002945:Cisplatin / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden
D000970:Antineoplastic Agents; D002945:Cisplatin