CT-based evaluation of tumor volume after intra-arterial chemotherapy of locally advanced carcinoma of the oral cavity: comparison with clinical remission rates.
OBJECTIVE
To assess the volume of locally advanced tumors of the oral cavity and the oropharynx before and after intra-arterial (i.a.) chemotherapy by means of computed tomography and to compare these data with clinically determined treatment response of the same patient population.


METHODS
Eighty-eight patients with histologically proven, advanced carcinoma of the oral cavity and/or the oropharynx (local tumor stages T3/4) received neoadjuvant i.a. chemotherapy with cisplatin as part of a multimodal therapeutic regimen, comprising (1) local chemotherapy, (2) surgery, and (3) combined radio-chemotherapy. Three weeks after the intervention, residual disease was evaluated radiologically by measurement of the tumor volume and clinically by inspection and palpation of the primary tumor according to WHO criteria.


RESULTS
Comparison of treatment response according to radiological and clinical criteria respectively revealed complete remission in 5% vs. 8% (p < 0.05), partial remission in 30% vs. 31%, stable disease in 61% vs. 58%, and tumor progression in 5% vs. 2%.


CONCLUSIONS
Radiological volumetry and clinical evaluation found comparable response rates after local chemotherapy. However, in patients with good response after local treatment, volumetric measurement with CT may help to distinguish between partial and complete remission. Thus, radiological tumor volumetry provides precise and differentiated information about tumor response and should be used as an additional tool in treatment monitoring after local chemotherapy.
Rohde
Stefan
S
Department of Neuroradiology, Ruprecht Karls University Medical School, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany. stefan.rohde@med.uni-heidelberg.de
Turowski
Bernd
B
Berkefeld
Joachim
J
Kovács
Adorján F
AF
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*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000000981:diagnostic imaging / Q000473:pathology; D009062:Mouth Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D009367:Neoplasm Staging / Q000379:methods; D012074:Remission Induction / Q000379:methods; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D047368:Tumor Burden
D000970:Antineoplastic Agents; D002945:Cisplatin