RADIOLOGICAL FOLLOW-UP OF NEOADJUVANT CHEMOTHERAPY FOR MALIGNANT

TUMORS OF THE ORAL CAVITY AND OROPHARYNX

 

Volodina V.D.

 

I.M. Sechenov First Moscow State Medical University (Sechenov University). Moscow, Russia.

P

urpose. To improve imaging techniques for monitoring of neoadjuvant chemotherapy in patients with malignant tumors of the oral cavity and oropharynx.

Materials and Methods. A total of 96 patients (100%) with newly diagnosed, histologically confirmed squamous cell carcinoma (SCC) of the oral cavity and/or oropharynx were enrolled in this study. All patients underwent contrast-enhanced multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) of the oropharyngeal region at different treatment stages: before neoadjuvant chemotherapy (NAT) (no earlier than 1 month prior), 7-14 days after two cycles, and 10-20 days after three cycles. MSCT was performed using a «Canon Aquilion ONE 640» scanner (Japan) and MRI was performed using a «Siemens Magnetom Aera» 1.5T scanner (Germany). Imaging findings were correlated with postoperative histopathological results.

Results. When performing MSCT and MRI of the oropharyngeal region with contrast enhancement, the results of studies of 96 patients (100%) were analyzed, including 63 (65,6%) men and 33 (34,4%) women, with an average age of 59 ± 12 years. The patients were divided into two groups depending on the location of the tumor: oral cancer (n=54; 56,3%) and oropharyngeal cancer (n=42; 43,7%). Tongue cancer accounted for the largest proportion (n=22; 22,9%) among malignant neoplasms of the oral cavity and oropharynx. Palate cancer was the least common (n=3; 3,2%).

According to MSCT and MRI data, a tumor was detected in all patients (n=96; 100%) before CT. After the 2nd course of CT, according to MSCT, the tumor was detected in 88 cases (91,6%), according to MRI – in 91 cases (94,7%). After the 3rd course of CT, according to MSCT, the tumor was detected in 76 cases (79%), according to MRI – in 78 cases (81,3%).

The effectiveness of radiological methods in the diagnosis of cancer of the oral cavity and/or oropharynx at the stages before and after neoadjuvant antitumor therapy was as follows: for MSCT with contrast enhancement, sensitivity was 83,7%, specificity was 93,8%, accuracy was 88,7%, for MRI with contrast enhancement, sensitivity was 92,6%, specificity was 95,2%, accuracy was – 93,9%.

Based on the results of the study, a clinical and radiological algorithm was developed for the examination of patients with oral and oropharyngeal cancer.

Discussion. The combined use of MRI and MSCT for the diagnosis of oropharyngeal cancer and evaluation of the effectiveness of neoadjuvant therapy demonstrated higher sensitivity, specificity and accuracy compared with the use of each method separately. An integrated approach in the diagnosis of oral and/or oropharyngeal cancer made it possible to accurately visualize bone structures using MSCT and soft tissues using MRI, which was important in planning further treatment tactics.

Conclusion. The developed tactics of clinical radiological examination increases the effectiveness of diagnosis and monitoring of neoadjuvant antitumor treatment of malignant tumors of the oral cavity and oropharynx. The proposed approach to evaluating the effectiveness of neoadjuvant chemotherapy in the treatment of oral and oropharyngeal cancer has allowed changing the treatment tactics of patients in 92% of cases.

 

Keywords: oral cavity squamous cell carcinoma, oropharyngeal cancer, neoadjuvant chemotherapy, MSCT, MRI.

 

Corresponding author: Volodina V.D., e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Volodina V.D. Radiological follow-up of neoadjuvant chemotherapy for malignant tumors of the oral cavity and oropharynx. REJR 2025; 15(3):86-99. DOI: 10.21569/2222-7415-2025-15-3-86-99.

Received:        13.05.25                 Accepted:       26.08.25