Open Access[ 18 F]‐Fluorodeoxyglucose Positron Emission Tomography Standardized Uptake Value as a Predictor of Adjuvant Chemotherapy Benefits in Patients With Nasopharyngeal Carcinoma
Author(s) -
Hsieh TeChun,
Hsieh Ching Yun,
Yang Tse Yen,
Chen Tzu Ting,
Lin Chen Yuan,
Lin ChingChan,
Hua Chung Hung,
Chiu ChangFang,
Yeh SuPeng,
Sher Yuh Pyng
Publication year - 2015
Publication title -
the oncologist
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.176
H-Index - 164
eISSN - 1549-490X
pISSN - 1083-7159
DOI - 10.1634/theoncologist.2014-0291
Subject(s) - medicine , nasopharyngeal carcinoma , chemotherapy , standardized uptake value , adjuvant , positron emission tomography , oncology , radiation therapy , stage (stratigraphy) , cisplatin , adjuvant chemotherapy , nuclear medicine , cancer , breast cancer , paleontology , biology
Background. The role of adjuvant chemotherapy for the treatment of nasopharyngeal carcinoma (NPC) is controversial, and the identification of adequate predictive factors is warranted. Therefore, we aimed to investigate whether the mean standardized uptake value (SUV) measured on [ 18 F]‐fluorodeoxyglucose (FDG) positron emission tomography (PET) could predict the survival benefits for NPC patients that receive adjuvant chemotherapy. Materials and Methods. The data for 174 NPC patients who underwent PET/computed tomography before chemoradiation between January 2004 and January 2012 were reviewed. The SUV 75% was recorded for primary tumors. All patients received intensity‐modulated radiotherapy and cisplatin‐based chemotherapy. Adjuvant chemotherapy consisted of 3 cycles of 75 mg/m 2 cisplatin and 1,000 mg/m 2 fluorouracil for 4 days. Results. The optimal cutoff value was 8.35 for SUV 75% , with 112 (64.4%) patients having lower SUV 75% and 62 (35.6%) having higher SUV 75% . Patients with lower SUV 75% had significantly better 5‐year overall survival (OS) and distant metastasis‐free survival. Multivariate analysis revealed that tumor stage, SUV 75% , and adjuvant chemotherapy were significant prognostic factors for OS. Patients with higher SUV 75% had significantly higher 5‐year OS rates with adjuvant chemotherapy than without adjuvant chemotherapy (84.3% vs. 32.4%, respectively; p < .001). However, in the lower SUV 75% group, no differences in 5‐year OS were observed between patients who received and those who did not receive adjuvant chemotherapy (92.4% vs. 93.3%, respectively; p = .682). Conclusion. The SUV 75% on FDG PET for primary tumors could successfully identify NPC patients who may benefit from adjuvant chemotherapy.