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Head and Neck Imaging |
1 From the Department of Radiology, University Hospitals, Herestraat 49, B-3000 Leuven, Belgium (R.H.); the Department of Radiology, the Netherlands Cancer Institute, Amsterdam (F.A.P.); and the Departments of Radiology (A.A.M.) and Radiation Oncology (J.T.P., W.M.M.), University of Florida College of Medicine, Gainesville. Received March 5, 1999; revision requested April 8; revision received May 19; accepted June 29. Address reprint requests to R.H. (e-mail: robert.hermans@uz.kuleuven.ac.be).
PURPOSE: To determine if follow-up computed tomography (CT) after definitive radiation therapy for laryngeal or hypopharyngeal (laryngopharyngeal) carcinoma allows the detection of local failure earlier than clinical examination alone.
MATERIALS AND METHODS: Pre– and post–radiation therapy follow-up CT scans in 66 patients were reviewed retrospectively. All patients underwent definitive hyperfractionated radiation therapy and were followed up clinically for at least 2 years after its completion. Post–radiation therapy CT scans (N = 153) were evaluated for posttreatment changes with a three-point score: A score of 1 represented expected posttreatment changes; 2, focal mass with a maximal diameter of less than 1 cm and/or asymmetric obliteration of laryngeal tissue planes; or 3, focal mass with a maximal diameter equal to or greater than 1 cm or estimated tumor volume reduction of less than 50%. All patients underwent the first posttreatment CT study 1–6 months after therapy. New or progressive laryngeal cartilage changes were noted. The clinical impression of the larynx at the time of each follow-up CT scan was also recorded.
RESULTS: In 12 of 29 (41%) patients with treatment failure at the primary site, follow-up CT scans were definite for local failure (score, 3) a mean of 5.5 months (median, 3.5 months; range, 1–17 months) before clinical examination results.
CONCLUSION: In many patients, follow-up CT shows local failure earlier than does clinical examination alone.
Index terms: Head and neck neoplasms, 271.373, 272.373 • Head and neck neoplasms, CT, 271.12112, 271.373, 272.12112, 272.373 • Head and neck neoplasms, therapeutic radiology, 271.1299, 272.1299 • Larynx, CT, 271.12112 • Larynx, neoplasms, 271.373 • Larynx, therapeutic radiology, 271.126
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