PROGNOSTIC-SIGNIFICANCE OF COMPUTED-TOMOGRAPHY IN TUMORS OF THE ORAL CAVITY AND OROPHARYNX TREATED WITH NEOADJUVANT CHEMOTHERAPY

Background: Despite its high response rate, the use of neoadjuvant che motherapy remains controversial. Pretherapeutic identification of subg roups of patients who are likely to respond to chemotherapy is of the utmost importance. Purpose: In this study, we have attempted to determ ine the relationship between specific radiological parameters and the response to neoadjuvant chemotherapy. In addition, we have determined ii these parameters could yield prognostic information on recurrence a nd/or survival. Patients and Methods: Fifty-four patients with a squam ous cell carcinoma of the oral cavity or base of tongue who had had a contrast-enhanced CT scan and neoadjuvant chemotherapy were included i n this analysis. All clinical, radiological, surgical, histological, a nd radiotherapeutical parameters as well as the follow-up data were an alyzed by a chi-square test. The method of Kaplan-Meyer was used to de termine disease-free intervals and crude survival. The log-rank method was used for testing differences in local failures and survival. Resu lts: Twenty-eight patients were classified as having isodense nodes an d 20 patients as having hypodense nodes. Nodal density was not related to tumor size or primary site. N stage was not correlated with the de nsity of the nodes. Patients with hypodense nodes had a significantly lower disease-free interval and survival than patients with isodense n odes. The relation between overall response to chemotherapy and the hy podensity of the nodes didn't reach a significant level. Conclusion: N o relation was found between overall response to chemotherapy and N-st age or tumor density. Disease-free interval and crude survival was str ongly related to response to chemotherapy. Copyright (C) 1997 by W.B. Saunders Company.