Tumor Blood Flow Is a Predictor of Radiotherapy Response in Patients With Nasopharyngeal Carcinoma

Xiujuan Cao; Jian Song; Juan Xu; Guanzhong Gong; Xinhua Yang; Ya Su; Lizhen Wang; Xiaodong Bai; Man Hu; Yong Yin

doi:10.3389/fonc.2021.567954

Tumor Blood Flow Is a Predictor of Radiotherapy Response in Patients With Nasopharyngeal Carcinoma

Front Oncol. 2021 Aug 6:11:567954. doi: 10.3389/fonc.2021.567954. eCollection 2021.

Authors

Xiujuan Cao^{1

2}, Jian Song³, Juan Xu², Guanzhong Gong⁴, Xinhua Yang², Ya Su⁴, Lizhen Wang⁴, Xiaodong Bai⁵, Man Hu², Yong Yin^{1

4}

Affiliations

¹ Department of Radiation Oncology, Shandong Cancer Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
² Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.
³ Medical Imageology, Shandong Medical College, Jinan, China.
⁴ Department of Radiation Oncology Physics and Technology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.
⁵ Department of Plastic Surgery, Southern University of Science and Technology Hospital, Shenzhen, China.

Abstract

Purpose: The aim of this study was to evaluate tumor blood flow (TBF) as a predictor of radiotherapy response for nasopharyngeal carcinoma (NPC).

Materials and method: A total of 134 patients were divided into two groups, the complete response (CR) group and the partial response (PR) group based on RECIST 1.1 recommendations. The statistical difference was evaluated for pre- and mid- or post-treatment TBF and changes of TBF for tumors and metastatic lymph nodes between CR and PR, respectively. The receiver operation characteristic (ROC) curve was utilized to evaluate the accuracy of TBF in predicting the response of radiation therapy. The association between TBF and SUVmax was also investigated.

Results: The reduction of TBF in CR was significantly lower than that in PR for primary tumors (P <0.001) and metastatic lymph nodes (P <0.001). The multivariate logistic regression analysis indicated that the reduction of TBF is an independent predictor of the response of radiation therapy for primary tumors (P <0.001) and metastatic lymph nodes (P <0.001). The accuracy of TBF reduction in predicting the response of radiation therapy was 0.817 in primary tumors and 0.924 in metastatic lymph nodes, respectively. No significant correlation was observed between the TBF values and SUVmax of primary tumors (r = -0.008, P = 0.954) and metastasis lymph nodes (r = -0.061, P = 0.652).

Conclusion: This study suggests that the reduction of TBF is a promising parameter for evaluating the response of radiation therapy.

Keywords: nasopharyngeal carcinoma; predictor; radiotherapy; response; tumor blood flow.