Unidimensional measurement may be superior to assess primary tumor response after neoadjuvant chemotherapy for nasopharyngeal carcinoma.
Application of current response evaluation criteria in solid tumors (RECIST 1.1) for assessment of irregularly shaped nasopharyngeal carcinoma (NPC) is a gray area with much ambiguity. Our aim was to compare unidimensional measurements (UDM) and bidimensional measurements (BDM) on magnetic resonance images in alternative planes for measurement of tumor response after neoadjuvant chemotherapy (NACT) in patients with locally advanced NPC. 59 patients with untreated non-metastatic NPC were prospectively enrolled. The size or change in size of the primary tumor and retropharyngeal nodes was assessed by UDM and BDM on axial and coronal planes before and after 2 cycles of NACT. Tumor volume was considered as the reference standard. Correlation between volume and diameter was analyzed using a general linear model. The degree of agreement and discordance of response classification based on different measures were evaluated with κ statistic and McNemar's test, respectively. Both axial UDM (RECIST 1.1) and axial BDM (WHO) showed a significant association with volumetric standard. However, the agreement of axial UDM with VM was better than that of axial BDM (κ value: 0.514 to 0.372). In addition, when increasing coronal planes to evaluate tumor response with UDM and BDM, an inferior agreement between coronal BDM and VM was still observed. Notably, coronal UDM showed the best consistency with volume (κ = 0.585). Hence, axial UDM showed better correlation with volumetric measurements than axial BDM. Since coronal UDM showed high correlation to VM, we suggest further research to assess its use for response assessment of NPC after NACT.
Department of Radiation Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, Fujian, China.|Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China.|Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China.
Chuanben
C
Chen
Department of Radiation Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, Fujian, China.|Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China.|Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China.
Xiurong
X
Lin
Department of Radiation Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, Fujian, China.|Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China.|Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China.
Yuanji
Y
Xu
Department of Radiation Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, Fujian, China.|Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China.|Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China.
Penggang
P
Bai
Department of Radiology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, Fujian, China.
Youping
Y
Xiao
Department of Radiation Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, Fujian, China.|Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China.|Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China.
Yuhui
Y
Pan
Department of Radiation Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, Fujian, China.|Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China.|Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China.
Chao
C
Li
Department of Radiation Oncology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, Fujian, China.|Shengli Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China.|Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fuzhou, Fujian, China.
Zhizhong
Z
Lin
Department of Radiotherapy, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
Mingwei
M
Zhang
Department of Radiology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, Fujian, China.
Yunbin
Y
Chen
D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols; D002277:Carcinoma / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology*; D020360:Neoadjuvant Therapy; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011446:Prospective Studies; D066066:Response Evaluation Criteria in Solid Tumors; D047368:Tumor Burden; D055815:Young Adult
magnetic resonance imaging; nasopharyngeal carcinoma; neoadjuvant chemotherapy; tumor measurement