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Interim FDG PET / CT for predicting the outcome in patients with head and neck cancer
Author(s) -
Chen ShangWen,
Hsieh TeChun,
Yen KuoYang,
Yang ShihNeng,
Wang YaoChing,
Chien ChunRu,
Liang JiAn,
Kao ChiaHung
Publication year - 2014
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.24826
Subject(s) - medicine , hazard ratio , interim , nuclear medicine , chemoradiotherapy , head and neck cancer , radiation therapy , positron emission tomography , interim analysis , proportional hazards model , mann–whitney u test , confidence interval , radiology , clinical trial , archaeology , history
Objectives/Hypothesis The study aimed to investigate the prognostic effects of interim 18 fluoro‐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