Prognostic assessment of sonography and tumor volumetry in advanced cancerof the head and neck by use of Doppler ultrasonography

OBJECTIVE: The objective of this trial was to examine the degree of tumor v ascularity in lymph node metastases as depicted by computer-assisted color Doppler sonography and the tumor volumes associated with prognosis in carci nomas of the oropharynx and hypopharynx after primary radiochemotherapy. PATIENTS AND METHODS: In a prospective trial, 25 patients with advanced squ amous cell carcinomas of the oropharynx and hypopharynx (stage IV UICC 1997 ) were treated with radiochemotherapy. The color Doppler findings were quan tified with a computer-assisted protocol that quantitatively describes colo r Doppler images by the relative color pixel density (CPD). As important pr ognostic cofactor, total tumor volume (TN) was calculated from CT sections and related to the degree of vascularity. RESULTS: Low CPD in neck metastases showed a correlation with better overal l survival. A high-CPD group and a high-TN group (median survival 10.1 mont hs) were determined and were compared with all other CPD/TTV combinations ( median survival 28.4 months); the difference in survival was significant (P = 0.002). CONCLUSION: The results indicate that high tumor Vascularity in combination with high TN indicates a particularly bad prognosis in patients treated wi th primary radiochemotherapy for head and neck cancer.