CT-based follow-up following radiotherapy or radiochemotherapy for locally advanced head and neck cancer; outcome and development of a prognostic model for regional control

This is the authors' abstract. We don't add key points for this paper.

OBJECTIVE: The purpose of this study was to make a prognostic model for regional relapse in head and neck cancer using clinical and CT parameters. METHODS: 183 patients with lymph node-positive head and neck cancer were treated between 2002 and 2012 with radiotherapy or concurrent chemoradiotherapy. CT studies pre- and post-treatment were reviewed for lymph node size and the presence of necrosis, extracapsular spread (ECS) and calcifications. For every patient, correlations with 3-year regional control (RC), metastasis-free survival (MFS), disease-free survival (DFS) and overall survival (OS) were made. RESULTS: 3-year outcome rates were as follows: local control of 84%, RC of 80%, MFS of 74%, DFS of 61% and OS of 63%. Pre-treatment nodal size and the presence of necrosis were associated with a poorer outcome. This was also the case for post-treatment lymph node size, the presence of necrosis and ECS. We developed a CT-based prognostic model for RC with an area under the curve of 0.78 (95% confidence interval 0.63; 0.85). CONCLUSION: We reached a good outcome in our patient cohort using a CT-based follow-up approach. A CT-based model was developed, which can aid in predicting RC. Advances in knowledge: A prognostic model is proposed, which can aid in predicting RC and the necessity for post-radiotherapy neck dissection using clinical parameters and parameters derived from the post-treatment CT study. This is the first article to propose a prognostic model for regional relapse in head and neck cancer based on these parameters.