Prediction of chemoradiotherapic response on hypopharynx and larynx carcinomas by high-resolution magnetic resonance angiography: a prospective cohort study

Abstract

Background: Hypopharynx and larynx carcinomas are ones of the most frequent tumours of head and neck area which are mainly composed of squamous cells. The majority part of those carcinomas are diagnosed in advanced stages when the election of the treatment is still controversial, choosing between surgery plus radiotherapy or chemoradiotherapy. One of the most important points for predicting the tumoural response to chemoradiotherapy is the exposure to hypoxia. High-resolution gadofosveset-enhanced magnetic resonance angiography is an innovative image technique that evaluates the vessels of the body, and recently there are some studies that have started using it in order to analyse the vascularization of carcinomas. Therefore, the vascular pattern could be a measure to estimate the grade of hypoxia exposure. Objective: The aim of this study is to analyse whether there is an association between the tumoural vascular pattern obtained by high-resolution gadofosveset-enhanced magnetic resonance angiography, and clinical and radiologic response of the tumour to chemoradiotherapy, in patients with locally advanced squamous cell carcinoma of hypopharynx and larynx. Methods: It will be an observational analytic prospective cohort study with a follow-up of 9.5 years, performed at Hospital Universitari Doctor Josep Trueta of Girona. Using a non-probabilistic consecutive sampling, patients aged 18 or more with the new diagnosis of locally advanced squamous cell carcinoma of hypopharynx or larynx will be recruited and divided into two groups depending on the vascular pattern of the tumour, that indirectly represents the tumoural exposition to hypoxia. The two groups will be followed in order to analyse clinic and radiologic response of the carcinoma to chemoradiotherapy, and consequently the overall and disease free survival during the follow-up period