Pameijer F A, Mancuso A A, Mendenhall W M, Parsons J T, Mukherji S K, Hermans R, Kubilis P S
Department of Radiology, University of Florida College of Medicine/Shands Hospital, Gainesville 32610, USA.
Head Neck. 1998 Mar;20(2):159-68. doi: 10.1002/(sici)1097-0347(199803)20:2<159::aid-hed10>3.0.co;2-h.
This study was undertaken to determine whether pretreatment computed tomography (CT) findings can predict local control in pyriform sinus carcinoma treated with definitive radiotherapy (RT).
Twenty-three patients with pyriform sinus carcinoma (T1: n = 5; T2: n = 18) were treated with high-dose RT and followed for a minimum of 2 years. Tumor volumes and extent were determined on pretreatment CT studies. The specific CT parameters assessed were analyzed as predictors of local control.
There was a significant decrease in local control rate for tumors over 6.5 mL (1 of 4 [25%]) relative to tumors under 6.5 mL (17 of 19 [89%]; p = .021). Sensitivity and specificity for local control using this cutoff were 94% and 60%, respectively. Tumor score, as a measure of anatomic extent, was also found to be a significant predictor of local control (p = .033). The local control rate was not influenced significantly by the presence of "minimal" apex disease (< 10 mm in greatest dimensions as measured on CT) but decreased significantly when "bulk" apex disease (> OR = 10 mm) was present (p = .027). Laryngeal cartilage sclerosis was not a significant predictor of outcome.
Computed tomography can stratify pyriform sinus carcinomas into groups more or less likely to be locally controlled with definitive RT.
