Prospective Study of PET/MRI Tumor Response During Chemoradiotherapy for Patients With Low-risk and Intermediate-risk p16-positive Oropharynx Cancer.

Autor:	Witek ME; Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Carbone Cancer Center.; Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, MD., Kimple RJ; Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Carbone Cancer Center.; UW Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health., Avey GD; Departments of Radiology., Burr AR; Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Carbone Cancer Center., Chandereng T; Department of Biostatistics, Columbia University, New York, NY., Yu M; UW Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health.; Biostatistics and Medical Informatics., Hu R; UW Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health.; Pathology and Laboratory Medicine., Wieland AM; Surgery., Labby ZE; Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Carbone Cancer Center., Bruce JY; UW Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health.; Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI., Brower JV; Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Carbone Cancer Center., Hartig GK; Surgery., Harari PM; Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Carbone Cancer Center.; UW Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health.
Jazyk:	angličtina
Zdroj:	American journal of clinical oncology [Am J Clin Oncol] 2022 May 01; Vol. 45 (5), pp. 202-207. Date of Electronic Publication: 2022 Apr 12.
DOI:	10.1097/COC.0000000000000910
Abstrakt:	Objective: The objective of this study was to examine tumor response with positron emission tomography (PET)/magnetic resonance imaging (MRI) during chemoradiotherapy as a predictor of outcome in patients with p16-positive oropharynx cancer. Materials and Methods: Patients with p16-positive oropharynx cancer were treated with chemoradiotherapy. Low-risk (LR) disease was defined as T1-T3 and N0-2b and ≤10 pack-years and intermediate-risk (IR) disease as T4 or N2c-3 or >10 pack-years. Patients underwent a PET/MRI scan pretreatment and at fraction 10. Change in value of imaging means were analyzed by analysis of variance. K-means clustering with Euclidean distance functions were used for patient clustering. Silhouette width was used to determine the optimal number of clusters. Linear regression was performed on all radiographic metrics using patient and disease characteristics. Results: Twenty-four patients were enrolled with 7 LR and 11 IR patients available for analysis. Pretreatment imaging characteristics between LR and IR patients were similar. Patients with LR disease exhibited a larger reduction in maximum standardized uptake value (SUV) compared with IR patients (P<0.05). Cluster analysis defined 2 cohorts that exhibited a similar intratreatment response. Cluster 1 contained 7 of 7 LR patients and 8 of 11 IR patients. Cluster 2 contained 3 of 11 IR patients. Cluster 2 exhibited significant differences compared with cluster 1 in the change in primary tumor peak SUV and largest lymph node median SUV. Conclusions: We identified that IR p16-positive oropharynx cancers exhibit heterogeneity in their PET/MRI response to chemoradiotherapy. These data support further study of intratreatment imaging response as a potential mechanism to identify patients with IR oropharynx cancer suitable for treatment deintensification. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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