Radiat Oncol J.
2018 Jun;36(2):95-102. 10.3857/roj.2017.00577.
Prognostic value of FDG PET/CT during radiotherapy in head and neck cancer patients
- Affiliations
-
- 1Department of Radiation Oncology, Seoul National University Boramae Medical Center, Seoul, Korea.
- 2Department of Nuclear Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.
- 3Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea.
- 4Department of Otolaryngology, Seoul National University Boramae Medical Center, Seoul, Korea.
- 5Department of Radiation Oncology, Chung-Ang University Hostpial, Seoul, Korea.
- 6Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea. entist@naver.com
- KMID: 2418869
- DOI: http://doi.org/10.3857/roj.2017.00577
Abstract
- PURPOSE
To evaluate the prognostic value of 18F-fluorodeoxyglucose positron-emission tomography (FDG PET) with computed tomography (CT) before and during radiotherapy (RT) in patients with head and neck cancer.
METHODS
Twenty patients with primary head and neck squamous cell carcinoma were enrolled in this study, of whom 6 had oropharyngeal cancer, 10 had hypopharyngeal cancer, and 4 had laryngeal cancer. Fifteen patients received concurrent cisplatin and 2 received concurrent cetuximab chemotherapy. FDG PET/CT was performed before RT and in the 4th week of RT. The parameters of maximum standardized uptake value, metabolic tumor volume, and total lesion glycolysis (TLG) of the primary tumor were measured, and the prognostic significance of each was analyzed with the Cox proportional hazards model.
RESULTS
Higher TLG (>19.0) on FDG PET/CT during RT was a poor prognostic factor for overall survival (OS) (p = 0.001) and progression-free survival (PFS) (p = 0.007). In the multivariate analysis, TLG during RT as a continuous variable was significantly associated with OS and PFS rate (p = 0.023 and p = 0.016, respectively). Tumor response worse than partial remission at 1 month after RT was another independent prognostic factor for PFS (p = 0.024).
CONCLUSIONS
Higher TLG of the primary tumor on FDG PET/CT during RT was a poor prognostic factor for OS and PFS in patients with head and neck cancer.
MeSH Terms
-
Carcinoma, Squamous Cell
Cetuximab
Cisplatin
Disease-Free Survival
Drug Therapy
Glycolysis
Head and Neck Neoplasms*
Head*
Humans
Hypopharyngeal Neoplasms
Laryngeal Neoplasms
Multivariate Analysis
Neck
Oropharyngeal Neoplasms
Positron-Emission Tomography
Positron-Emission Tomography and Computed Tomography*
Proportional Hazards Models
Radiotherapy*
Tumor Burden
Cetuximab
Cisplatin
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