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- Title
Interim FDG PET/ CT for predicting the outcome in patients with head and neck cancer.
- Authors
Chen, Shang‐Wen; Hsieh, Te‐Chun; Yen, Kuo‐Yang; Yang, Shih‐Neng; Wang, Yao‐Ching; Chien, Chun‐Ru; Liang, Ji‐An; Kao, Chia‐Hung
- Abstract
Objectives/Hypothesis The study aimed to investigate the prognostic effects of interim 18fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (PET/CT) during definitive radiotherapy (RT) or chemoradiotherapy (CRT) in patients with head and neck cancer. Study Design This is a prospectively treatment study. Methods The pretreatment and interim PET/CT images of 51 patients with advanced pharyngeal cancers receiving definitive RT/CRT were evaluated prospectively. The interim PET/CT images were taken at a cumulative RT dose ranging from 41.4 to 46.8 Gy. The maximum standardized uptake value (SUVm) of the interim PET/CT and the reduction ratio of the SUVm (SRR) between the two images were measured. The differences between patients with or without local failures were examined using the Mann-Whitney test. Overall survival (OS), disease-free survival (DFS), and primary and nodal relapse-free survival rates were calculated using the Kaplan-Meier method. Independent prognosticators were identified using Cox regression analysis. Results After a median follow-up duration of 23 months, a higher interim SUVm was associated with local failures. Conducting a multivariate analysis revealed that a SUVmax reduction ratio of primary tumor (SRR-P) < 0.64 was associated with the inferior OS (hazard ratio 2.64; P =0.035) and DFS (hazard ratio 2.33; P = 0.045). Patients who had tumors with an SRR-P < 0.64 had a considerably lower 2-year OS and DFS compared with those who had SRR-P ≥ 0.64 (47% vs. 66%; 41% vs. 64%). Conclusion A higher interim SUVm was associated with local recurrence. In addition, patients with a lower SRR-P should be considered to be at risk of primary failure. Level of Evidence 4. Laryngoscope, 124:2732-2738, 2014
- Subjects
POSITRON emission tomography; COMPUTED tomography; RADIOTHERAPY; HEAD &; neck cancer patients; HEAD &; neck cancer treatment
- Publication
Laryngoscope, 2014, Vol 124, Issue 12, p2732
- ISSN
0023-852X
- Publication type
Article
- DOI
10.1002/lary.24826