Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
AJNR Am J Neuroradiol. 2011 Apr;32(4):778-84. doi: 10.3174/ajnr.A2376. Epub 2011 Feb 24.
Patients with HNSCC have a poor prognosis and development of imaging biomarkers that predict long-term outcome might aid in planning optimal treatment strategies. Therefore, the purpose of the present study was to predict disease-free survival in patients with HNSCC by using pretreatment K(trans) measured from dynamic contrast-enhanced MR imaging.
Sixty-six patients with HNSCC were recruited from January 2005 to October 2008. Three patients were excluded because they underwent upfront neck dissection, and 6 patients were excluded due to suboptimal MR imaging data or being lost to follow-up. Disease-free survival was measured in the remaining 57 patients from the end date of chemoradiation therapy. In patients who died, the end point was the date of death, while in surviving patients the date of last clinical follow-up was used as the end point. Pretreatment K(trans) and nodal volume were computed from the largest metastatic node, and median pretreatment K(trans) and volume were used to divide patients into 2 groups (at or above the threshold value [group I] and below the threshold value [group II]. Disease-free survival was analyzed by the Kaplan-Meier method, and the results were compared by using a logrank test with K(trans) and nodal volume as predictors. A P value <.05 was considered significant.
Thirteen of 57 patients had died of HNSCC by the last follow-up period (March 31, 2009). Patients with higher pretreatment K(trans) values had prolonged disease-free survival compared with patients with lower K(trans) values (P=.029). However, there was no significant difference in disease-free survival when nodal volume was used as a predictor (P=.599).
Pretreatment K(trans) may be a useful prognostic marker in HNSCC.
头颈部鳞状细胞癌（HNSCC）患者预后较差，开发能够预测长期预后的影像学生物标志物可能有助于制定最佳治疗策略。因此，本研究旨在通过使用动态对比增强磁共振成像（DCE-MRI）测量的预处理 Ktrans 值预测 HNSCC 患者的无病生存。
2005 年 1 月至 2008 年 10 月，招募了 66 例 HNSCC 患者。由于 3 例患者接受了 upfront 颈清扫术，6 例患者由于 MR 成像数据不理想或失访而被排除在外。对其余 57 例患者从放化疗结束之日起测量无病生存。在死亡患者中，终点为死亡日期，而在存活患者中，终点为最后一次临床随访日期。从最大转移性淋巴结计算预处理 Ktrans 和淋巴结体积，中位数预处理 Ktrans 和体积用于将患者分为 2 组（高于或低于阈值[组 I]和低于阈值[组 II]。通过 Kaplan-Meier 法分析无病生存，并通过对数秩检验比较 Ktrans 和淋巴结体积作为预测因子的结果。P 值<.05 被认为具有统计学意义。
在最后一次随访期间（2009 年 3 月 31 日），57 例患者中有 13 例死于 HNSCC。与 Ktrans 值较低的患者相比，Ktrans 值较高的患者无病生存时间更长（P=.029）。然而，当淋巴结体积作为预测因子时，无病生存无显著差异（P=.599）。
预处理 Ktrans 可能是 HNSCC 的一种有用的预后标志物。
