Imaging Method Has Potential to Predict Effectiveness of Induction Chemotherapy in Patients With Head and Neck Cancer

Researchers identified a potential new method for predicting which patients with head and neck cancer will benefit most from chemotherapy. Their new method was described in Oral Oncology (2015; doi:10.1016/j.oraloncology.2015.01.013).

These patients commonly receive pretreatment induction chemotherapy, before surgery or radiotherapy, to reduce the risk of disease spread. However, pretreatment is less effective in tumors with poor blood flow.

Previous studies have shown that CT scans can be used to assess tumor blood flow. Going beyond those results, researchers at The University of Manchester and The Christie NHS Foundation Trust, both part of the Manchester Cancer Research Centre in the United Kingdom, have explored the use of MRI scans in predicting which patients would benefit from induction chemotherapy.

"It's also important to identify those patients who are unlikely to respond to induction therapy so that we can skip ahead in the treatment pathway and offer them potentially more effective treatments and hopefully improve their outcome,” said study leader Professor Catharine West, PhD.

The team used an imaging technique known as dynamic contrast-enhanced MRI (DCE-MRI), where a contrast agent tracer is injected into a patient's vein whilst they have a series of MRI scans taken. This allows scientists and doctors to investigate the blood flow and vessel structure of a patient's tumor.

They found that determining blood flow of a patient's tumor before induction therapy could predict response to treatment. The group reported that those with high tumor blood flow were more likely to respond to pretreatment.

"Delivery and effectiveness of chemotherapy appears to be better in tumors with higher blood flow. However, amongst those patients with lower measured tumor blood flow, more work is needed to determine those who will and won't respond,” said coauthor Jonathan Bernstein, MD, who is now at Princess Margaret Cancer Centre in Toronto, Ontario, Canada.

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