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Predictive potential of dynamic contrast-enhanced MRI and plasma-derived angiogenic factors for response to concurrent chemoradiotherapy in human papillomavirus-negative oropharyngeal cancer

Alja Longo

Alja Longo

  • Institute of Radiology, University Medical Centre LjubljanaLjubljana, Slovenia
  • Faculty of Medicine, University of LjubljanaLjubljana, Slovenia
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Longo, Alja
, 
Petra Hudler

Petra Hudler

Institute of Biochemistry and Molecular Genetics, Faculty of Medicine, University of LjubljanaLjubljana, Slovenia
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Hudler, Petra
, 
Primoz Strojan

Primoz Strojan

  • Faculty of Medicine, University of LjubljanaLjubljana, Slovenia
  • Institute of OncologyLjubljana, Slovenia
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Strojan, Primoz
, 
Gaber Plavc

Gaber Plavc

  • Faculty of Medicine, University of LjubljanaLjubljana, Slovenia
  • Institute of OncologyLjubljana, Slovenia
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Plavc, Gaber
, 
Lan Umek

Lan Umek

Faculty of Public Administration, University of LjubljanaLjubljana, Slovenia
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Umek, Lan
 et 
Katarina Surlan Popovic

Katarina Surlan Popovic

  • Institute of Radiology, University Medical Centre LjubljanaLjubljana, Slovenia
  • Faculty of Medicine, University of LjubljanaLjubljana, Slovenia
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Popovic, Katarina Surlan
  
15 sept. 2024
Predictive potential of dynamic contrast-enhanced MRI and plasma-derived angiogenic factors for response to concurrent chemoradiotherapy in human papillomavirus-negative oropharyngeal cancer's Cover Image
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Catégorie d'article: Research Article
Publié en ligne: 15 sept. 2024
Pages: 366 - 375
Reçu: 24 mai 2024
Accepté: 22 juil. 2024
DOI: https://doi.org/10.2478/raon-2024-0044
Mots clés
© 2024 Alja Longo et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Figure 1.

A correlation heatmap visualising perfusion parameters alongside plasma concentrations of angiogenic factors before concurrent chemoradiotherapy (cCRT) initiation (left) and after receiving 20 Gy radiotherapy (right).
A correlation heatmap visualising perfusion parameters alongside plasma concentrations of angiogenic factors before concurrent chemoradiotherapy (cCRT) initiation (left) and after receiving 20 Gy radiotherapy (right).

Figure 2.

Co-registered volumes of interest (VOI) and color-coded ktrans maps, together with concentration curves alongside corresponding ktrans values before treatment (upper section) and intra-treatment after receiving 20 Gy radiotherapy (bottom section) in a representative responder patient.
Co-registered volumes of interest (VOI) and color-coded ktrans maps, together with concentration curves alongside corresponding ktrans values before treatment (upper section) and intra-treatment after receiving 20 Gy radiotherapy (bottom section) in a representative responder patient.

Figure 3.

Co-registered volumes of interest (VOI) and color-coded ktrans maps, together with concentration curves alongside corresponding ktrans values before treatment (upper section) and intra-treatment after receiving 20 Gy radiotherapy (bottom section) in a representative non-responder patient.
Co-registered volumes of interest (VOI) and color-coded ktrans maps, together with concentration curves alongside corresponding ktrans values before treatment (upper section) and intra-treatment after receiving 20 Gy radiotherapy (bottom section) in a representative non-responder patient.

Figure 4.

Graphical presentation of the classification tree model.cCRT = concurrent chemoradiotherapy; VEGF = vascular endothelial growth factor
Graphical presentation of the classification tree model.cCRT = concurrent chemoradiotherapy; VEGF = vascular endothelial growth factor

Expression of plasma angiogenic factors for responders and non-responders: mean values, 95% confidence interval (CI) and corresponding p-values

Plasma Angiogenic Factor Responders (n = 15) Non-responders (n = 9) p
VEGF (95% CI) pg/mL
  Before treatment 66.9 (58.1–75.7) 50.2 (41.8–58.5) 0.011*
  After 20 Gy 68.4 (61.0 –75.7) 48.0 (40.4–55.5) 0.0006**
  10–12 weeks after cCRT completion 74.7 (50.8–98.6) 49.0 (38.5–59.5) 0.010*
PDGF-AB (95% CI) pg/mL
  Before treatment 2826.6 (1909.3–3743.9) 2430.6 (1179.1–3682.1) 0.431
  After 20 Gy 2496.0 (2105.8–2886.2) 1799.1 (1319.3–22789) 0.021*
  10–12 weeks after cCRT completion 1513.5 (902.7–2124.3) 1468.5 (779.1–2157.9) 0.919
ANG (95% CI) pg/mL
  Before treatment 2140.8 (1588.2–2693.4) 1218.0 (223.0 –2213.0) 0.060
  After 20 Gy 2124.1 (1653.4–2594.9) 1438.0 (405.6–2470.4) 0.131
  10–12 weeks after cCRT completion 1898.1 (1248.7–2547.6) 1384.8 (255.7–2513.9) 0.347
THBS1 (95% CI) ng/mL
  Before treatment 1113.2 (1069.3–1157.2) 1115.6 (1055.8–1175.5) 0.943
  After 20 Gy 1112.3 (1051.5–1173.1) 1162.7 (1064.2–1261.2) 0.257
  10–12 weeks after cCRT completion 1061.2 (1008.8–1113.8) 1136.8 (1002.9–1270.7) 0.210
END (95% CI) pg/mL
  Before treatment 64792.6 (52731.7–76853.4) 59350.6 (47299.1–71402.1) 0.521
  After 20 Gy 71269.2 (55039.7–87498.7) 59636.7 (48124.0 –71149.5) 0.283
  10–12 weeks after cCRT completion 84744.3 (65061.5–104427.2) 74754.7 (54514.5–94994.9) 0.475
CTGF (95% CI) pg/mL
  Before treatment 32.6 (13.9–51.2) 24.4 (14.4–34.5) 0.976
  After 20 Gy 31.2 (24.1–122.8) 23.5 (12.3–34.8) 0.721
  10–12 weeks after cCRT completion 26.1 (15.7–36.6) 23.2 (15.1–31.3) 1

Summary of patient, tumour and treatment characteristics

Number of patients 25
Age, median (range) 60 (45–70)
Male gender (%) 25 (100)
Primary location (%)
  Oropharynx 25 (100)
Stage (%)
  III 5 (20)
  IVa 8 (32)
  IVb 12 (48)
Radiotherapy dose (Gy), median (range) 70 (68–70)
Concomitant chemotherapy, median no. of cycles (range) 6 (1–7)

Correlations between dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) perfusion parameters and biochemical parameters, along with their respective Spearman's rho and p-values

Time-point DCE-MRI parameter Biochemical parameter Spearman rho p
Before treatment kep VEGF 0.433 0.034*
kep ANG 0.420 0.058
After 20 Gy ktrans THBS1 −0.453 0.026*
ktrans VEGF 0.362 0.083
iAUC VEGF 0.391 0.056
iAUC CTFG −0.315 0.134

A summary of tumour perfusion characteristics for responders and nonresponders: mean values, standard deviations (SD), and corresponding p-values

DCE-MRI parameter Responders (n = 15) Non-responders (n = 9) p
ktrans (SD)
  Before treatment 0.270 (0.087) 0.169 (0.062) 0.006**
  After 20 Gy 0.289 (0.067) 0.215 (0.027) 0.007**
  Δ 0.019 (0.060) 0.047 (0.078) 0.326
kep (SD)
  Before treatment 0.924 (0.231) 0.817 (0.258) 0.144
  After 20 Gy 0.819 (0.229) 0.709 (0.086) 0.065
  Δ −0.105 (0.274) −0.108 (0.245) 0.980
Ve (SD)
  Before treatment 0.306 (0.082) 0.237 (0.108) 0.092
  After 20 Gy 0.366 (0.086) 0.347 (0.107) 0.636
  Δ 0.059 (0.093) 0.109 (0.196) 0.721
iAUC (SD)
  Before treatment 0.334 (0.109) 0.220 (0.092) 0.015*
  After 20 Gy 0.361 (0.070) 0.336 (0.099) 0.468
  Δ 0.027 (0.120) 0.116 (0.183) 0.676
Langue:
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Sujets de la revue:
Médecine, Médecine clinique, Médecine interne, Hématologie, oncologie, Radiologie
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