ABSTRACT
Objective To study the DCE-MRI findings of laryngeal and hypopharyngeal carcinoma.Methods 26 new patients di-agnosed laryngeal and hypopharyngeal cancer by pathology were collected and took DCE-MRI before therapy.The TIC type,ADC value,peak time (Tpeak),peak signal enhancement percentage (SERmax),positive enhancement integral(PEI),maximum slope of increase(MSI)and maximum slope of decrease(MSD)were obtained respectively.These semi-quantitative parameters of primary cancer,normal pharyngeal tissue and the same layer neck muscles were compared and P 0.05 )was found.Different b values (b = 300 s/mm2 , 500 s/mm2 )for ADC values were significantly different.There was statistical significance in semi-parameters among the primary cancer,normal pharyngeal wall tissue and the same layer neck muscles.Setting MSI value 58.32 threshold to distinguish abnormal and normal tissues,sensitivity and specificity both were 84.6%.Conclusion DCE-MRI can reflect morphology and signal differences among neck muscles,normal and abnormal laryngeal and hypopharyngeal tissues,providing help for diagnosis of primary carcino-ma.
ABSTRACT
This study was conducted to evaluate the efficacy of the neoadjuvant chemotherapy and radiation therapy in treatment of patients with advanced hypopharyngeal cancer which is notorious for its poor prognosis and severe surgical morbidity with functional deficits. Medical records of 62 patients with squamous cell carcinoma of the hypopharynx, Stage III or IV(AJCC, 1992), were retrospectively reviewed. Neoadjuvant chemotherapy showed an overall response rate of 87% and a complete remission(CR) rate was 67% following chemotherapy and radiation therapy. The patients who did not show CR after chemotherapy had a high likelihood of treatment failure, even though they achieved CR following subsequent radiotherapy. Thirteen of 30 patients were able to preserve their larynges for more than three years by chemotherapy and radiation. This regimen appeared to be as effective as radical surgery with postoperative radiation therapy without comprise of survival. To improve the cure rates, we need to develop better strategies to increase CR rates with chemotherapy and figure out the best treatment option for patients who are partially or non-responsive to chemotherapy.