INVESTIGATION OF THE RELATIONSHIP OF COMPUTED TOMOGRAPHY HISTOGRAM ANALYSIS WITH SURVIVAL TIME AND LOCAL CONTROL TIME IN HEAD AND NECK SQUAMOUS CELL CARCINOMA TREATED WITH CHEMORADIOTHERAPY
Journal Title: Kocatepe Medical Journal - Year 2023, Vol 24, Issue 2
Abstract
OBJECTIVE: This study aimed to evaluate the association between computed tomography (CT) histogram analysis and overall survival and local control in head and neck squamous cell carcinoma (HNSCC) treated with chemoradiotherapy. MATERIAL AND METHODS: Data archive and CT images from the ‘HNSCC’ study, which is publicly available on ‘The Cancer Imaging Archive’ website, were used in this study. Patients with known Human papilloma virus (HPV) status of the tumor who were treated with concurrent chemoradiotherapy and had pretreatment contrast-enhanced neck CT examination with a slice thickness of 1.3 mm were included. Histogram analysis was performed on 112 tumors and 98 lymphadenopathies. Tumor and lymphadenopathy boundaries, including cystic and necrotic areas, were manually drawn from a single axial CT slice where the lesion size was the largest. Then, histogram parameters [mean, variance, skewness, kurtosis, 1st percentile (P), 10th P, 50th P, 90th P, 99th P] were calculated from the corresponding areas. Kaplan Meier method and univariate and multivariate Cox proportional hazard models were used to examine the association between CT histogram parameters and overall survival and local control. RESULTS: 95 males and 17 females were included in this study (mean age 59±9.54 years). Mean overall survival was 69.3 months, local control duration was 68.4 months, and the five-year survival rate was 84%. Multivariate Cox proportional hazard model adjusted for age, sex, smoking, HPV status, and primary tumor T (tumor), N (lymph node), and TNM (tumor-lymph node-metastasis) stages showed that mean, 50th P, 90th P, 99th P values of the lymphadenopathy were independent predictors of overall survival, and mean, 1st P, 10th P values of the tumor were independent predictors of local control. CONCLUSIONS: CT histogram analysis could serve as a pretreatment noninvasive biomarker for predicting overall survival and local control in HNSCC treated with chemoradiotherapy.
Authors and Affiliations
Sevtap ARSLAN Yasin SARIKAYA
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