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MRI could predict response to induction chemotherapy in head & neck cancer


MRI scans may be capable of predicting whether a patient with head & neck cancer will respond to induction chemotherapy, suggests a new study published recently in Oral Oncology.

Individuals with head & neck cancer will frequently receive induction chemotherapy prior to other treatment (surgery or radiotherapy) in an effort to reduce the potential of the disease spreading. However, the success of this course of chemotherapy is known to be dependent upon the blood flow within the tumor – efficacy being reduced in areas of poor blood flow.

The new article states that non-response to chemotherapy occurs in 30% of head and neck squamous cell carcinomas. As Catherine West, lead author from the University of Manchester (UK), explained: “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.”

Previous studies have confirmed the potential of CT scans as a tool for assessing blood flow within a tumor. This investigation aimed to gauge the potential of MRI scans in observing tumor blood flow and predicting which patients would benefit from induction chemotherapy in a group of 50 enrolled individuals.

Employing dynamic contrast-enhanced MRI to blood flow and vessel formation within an individual patient’s tumor, the team determined that blood flow assessed using MRI could predict treatment response.

Jonathan Bernstein, a co-author on the paper also from University of Manchester, commented: “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.”

Sources: Bernstein JM, Kershaw LE, Withey SB et al. Tumor plasma flow determined by dynamic contrast-enhanced MRI predicts response to induction chemotherapy in head and neck cancer. Oral Oncol. doi: 10.1016/j.oraloncology.2015.01.013 (2015); University of Manchester press release