Pretreatment and early intratreatment prediction of clinicopathologic response of head and neck cancer to chemoradiotherapy using 1 H-MRS

Abstract

Purpose: To determine if choline (cho) identified by proton magnetic resonance spectroscopy ( 1 H-MRS) performed pretreatment and early in the course of treatment predicts clinicopathologic response of head and neck squamous cell carcinoma (HNSCC). Materials and Methods: In all, 60 patients with HNSCC scheduled to undergo concurrent chemoradiotherapy or radiotherapy alone were recruited. 1 H-MRS was performed pretreatment and early intratreatment (2 weeks after start of treatment). Cho:creatine and cho:water ratios at each timepoint and change in the ratios between the two timepoints were correlated with locoregional failure, distant metastases, overall survival, and cancer-related death. Statistical analysis was performed using logistic regression and chi-square and a P-value of < 0.05 was considered statistically significant. Results: Cho was identified in 47/49 successful pretreatment spectra and 42 of these 47 underwent successful 1H-MRS early intratreatment, of which 21 showed persistent cho. Locoregional failure occurred in 15, distant metastases in 6, and death in 15 patients; the follow-up period in survivors ranged from 13-64 months (mean, 39 months). No statistically significant correlation was found between 1 H-MRS parameters and clinical endpoints. Conclusion: The pretreatment cho and change in cho early during a course of treatment did not predict clinical outcome. © 2010 Wiley-Liss, Inc.