Predictive Potential of Dynamic Contrast-Enhanced MRI and Plasma-derived Angiogenic Factors for Response to Concurrent Chemoradiotherapy in Human Papillomavirus-negative Oropharyngeal Cancer
Abstract
BACKGROUND: Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) can assess tumour vascularity, which depends on the process of angiogenesis and affects tumour response to treatment. Our study explored the associations between DCE-MRI parameters and the expression of plasma angiogenic factors in HPV-negative head and neck cancer, as well as their predictive value for response to concurrent chemoradiotherapy (cCRT).
METHODS: 25 patients with locally advanced HPV-negative oropharyngeal carcinoma were prospectively enrolled in the study. DCE-MRI and blood plasma sampling were conducted before, at 20 Gy, and after the completion of cCRT. Perfusion parameters ktrans, kep, Ve, iAUC and plasma expression levels of angiogenic factors VEGF, CTGF, PDGF-AB, ANG, END and THBS1 were measured at each time-point. Patients were stratified into responders and non-responders based on clinical evaluation. Differences and correlations between measures were used to generate prognostic models for response prediction.
RESULTS: Higher ktrans and higher plasma VEGF levels successfully discriminated responders from non-responders across all measured time-points, whereas higher iAUC and higher plasma PDGF-AB levels were also discriminative at selected time points. Using early intra-treatment measurements of ktrans and VEGF, a predictive model was created with cut-off values of 0.259 min⁻¹ for ktrans and 62.5 pg/mL for plasma VEGF.
CONCLUSIONS: Early intra-treatment DCE-MRI parameter ktrans and plasma VEGF levels may be valuable early predictors of response to cCRT in HPV-negative oropharyngeal cancer.
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Copyright (c) 2024 Alja Longo, Petra Hudler, Primož Strojan, Gaber Plavc, Lan Umek, Katarina Šurlan Popović
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