Open AccessVolumetric PET/CT parameters predict local response of head and neck squamous cell carcinoma to chemoradiotherapy
Author(s) -
Hanamoto Atsushi,
Tatsumi Mitsuaki,
Takenaka Yukinori,
Hamasaki Toshimitsu,
Yasui Toshimichi,
Nakahara Susumu,
Yamamoto Yoshifumi,
Seo Yuji,
Isohashi Fumiaki,
Ogawa Kazuhiko,
Hatazawa Jun,
Inohara Hidenori
Publication year - 2014
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.295
Subject(s) - medicine , head and neck squamous cell carcinoma , nuclear medicine , confidence interval , chemoradiotherapy , receiver operating characteristic , head and neck cancer , area under the curve , standardized uptake value , odds ratio , logistic regression , nasopharyngeal carcinoma , cancer , oncology , radiation therapy , positron emission tomography
It is not well established whether pretreatment 18 F‐FDG PET/CT can predict local response of head and neck squamous cell carcinoma (HNSCC) to chemoradiotherapy (CRT). We examined 118 patients: 11 with nasopharyngeal cancer (NPC), 30 with oropharyngeal cancer (OPC), and 77 with laryngohypopharyngeal cancer (LHC) who had completed CRT. PET/CT parameters of primary tumor, including metabolic tumor volume (MTV), total lesion glycolysis (TLG), and maximum and mean standardized uptake value (SUV max and SUV mean ), were correlated with local response, according to primary site and human papillomavirus (HPV) status. Receiver‐operating characteristic analyses were made to access predictive values of the PET/CT parameters, while logistic regression analyses were used to identify independent predictors. Area under the curve ( AUC ) of the PET/CT parameters ranged from 0.53 to 0.63 in NPC and from 0.50 to 0.54 in OPC. HPV‐negative OPC showed AUC ranging from 0.51 to 0.58, while all of HPV‐positive OPCs showed complete response. In contrast, AUC ranged from 0.71 to 0.90 in LHC. Moreover, AUCs of MTV and TLG were significantly higher than those of SUV max and SUV mean ( P < 0.01). After multivariate analysis, high MTV >25.0 mL and high TLG >144.8 g remained as independent, significant predictors of incomplete response compared with low MTV (odds ratio [OR], 13.4; 95% confidence interval [CI], 2.5–72.9; P = 0.003) and low TLG (OR, 12.8; 95% CI, 2.4–67.9; P = 0.003), respectively. In conclusion, predictive efficacy of pretreatment 18 F‐FDG PET/CT varies with different primary sites and chosen parameters. Local response of LHC is highly predictable by volume‐based PET/CT parameters.