Prognostic significance of computed tomography in tumors of the oral cavity and oropharynx treated with neoadjuvant chemotherapy.

BACKGROUND

Despite its high response rate, the use of neoadjuvant chemotherapy remains controversial. Pretherapeutic identification of subgroups of patients who are likely to respond to chemotherapy is of the utmost importance.

PURPOSE

In this study, we have attempted to determine the relationship between specific radiological parameters and the response to neoadjuvant chemotherapy. In addition, we have determined if these parameters could yield prognostic information on recurrence and/or survival.

PATIENTS AND METHODS

Fifty-four patients with a squamous cell carcinoma of the oral cavity or base of tongue who had had a contrast-enhanced CT scan and neoadjuvant chemotherapy were included in this analysis. All clinical, radiological, surgical, histological, and radiotherapeutical parameters as well as the follow-up data were analyzed by a chi-square test. The method of Kaplan-Meyer was used to determine disease-free intervals and crude survival. The log-rank method was used for testing differences in local failures and survival.

RESULTS

Twenty-eight patients were classified as having isodense nodes and 20 patients as having hypodense nodes. Nodal density was not related to tumor size or primary site. N stage was not correlated with the density of the nodes. Patients with hypodense nodes had a significantly lower disease-free interval and survival than patients with isodense nodes. The relation between overall response to chemotherapy and the hypodensity of the nodes didn't reach a significant level.

CONCLUSION

No relation was found between overall response to chemotherapy and N-stage or tumor density. Disease-free interval and crude survival was strongly related to response to chemotherapy.