Prognostic value of nodal SUVmax of 18F-FDG PET/CT in nasopharyngeal carcinoma treated with intensity-modulated radiotherapy
| Autor: | Yeon-Sil Kim, Myungsoo Kim, So Jung Lee, Sea-Won Lee, Seok Hyun Son, Chul-Seoung Kay, Hye Jin Kang |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Univariate analysis
medicine.diagnostic_test business.industry medicine.medical_treatment Hazard ratio Standardized uptake value medicine.disease Confidence interval Tomotherapy 030218 nuclear medicine & medical imaging Radiation therapy 03 medical and health sciences 0302 clinical medicine Oncology Nasopharyngeal carcinoma Positron emission tomography 030220 oncology & carcinogenesis medicine Radiology Nuclear Medicine and imaging business Nuclear medicine |
| Zdroj: | Radiation Oncology Journal. 35:306-316 |
| ISSN: | 2234-3156 2234-1900 |
| DOI: | 10.3857/roj.2017.00115 |
| Popis: | PURPOSE To investigate the predictive role of maximum standardized uptake value (SUVmax) of 2-[18F]fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in nasopharyngeal cancer patients treated with intensity-modulated radiotherapy (IMRT). MATERIALS AND METHODS Between October 2006 and April 2016, 53 patients were treated with IMRT in two institutions and their PET/CT at the time of diagnosis was reviewed. The SUVmax of their nasopharyngeal lesions and metastatic lymph nodes (LN) was recorded. IMRT was delivered using helical tomotherapy. All patients except for one were treated with concurrent chemoradiation therapy (CCRT). Correlations between SUVmax and patients' survival and recurrence were analyzed. RESULTS At a median follow-up time of 31.5 months (range, 3.4 to 98.7 months), the 3-year overall survival (OS) and disease-free survival (DFS) rates were 83.2% and 77.5%, respectively. In univariate analysis, patients with a higher nodal pre-treatment SUVmax (≥ 13.4) demonstrated significantly lower 3-year OS (93.1% vs. 55.5%; p = 0.003), DFS (92.7% vs. 38.5%; p < 0.001), locoregional recurrence-free survival (100% vs. 50.5%; p < 0.001), and distant metastasis-free survival (100% vs. 69.2%; p = 0.004), respectively. In multivariate analysis, high pre-treatment nodal SUVmax (≥ 13.4) was a negative prognostic factor for OS (hazard ratio [HR], 7.799; 95% confidence interval [CI], 1.506-40.397; p = 0.014) and DFS (HR, 9.392; 95% CI, 1.989-44.339; p = 0.005). CONCLUSIONS High pre-treatment nodal SUVmax was an independent prognosticator of survival and disease progression in nasopharyngeal carcinoma patients treated with IMRT in our cohort. Therefore, nodal SUVmax may provide important information for identifying patients who require more aggressive treatment. |
| Databáze: | OpenAIRE |
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