Therapy Response Assessment and Patient Outcomes in Head and Neck Squamous Cell Carcinoma: FDG PET Hopkins Criteria Versus Residual Neck Node Size and Morphologic Features
| Autor: | Rick Arthur Wray, Arman Rahmim, Rathan M. Subramaniam, Sara Sheikhbahaei, Charles Marcus, Regan Ferraro, Elcin Zan |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Neoplasm Residual Residual 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Fluorodeoxyglucose F18 Therapy assessment Medicine Humans Radiology Nuclear Medicine and imaging In patient Head and neck Retrospective Studies PET-CT business.industry General Medicine Chemoradiotherapy Middle Aged medicine.disease Prognosis Head and neck squamous-cell carcinoma Primary tumor Survival Rate Therapy response Head and Neck Neoplasms 030220 oncology & carcinogenesis Lymphatic Metastasis Positron-Emission Tomography Carcinoma Squamous Cell Female Radiology Radiopharmaceuticals business Nuclear medicine |
| Zdroj: | AJR. American journal of roentgenology. 207(3) |
| ISSN: | 1546-3141 |
| Popis: | This study investigates the prognostic value of (18)F-FDG PET/CT qualitative therapy assessment (Hopkins criteria) in patients with head and neck squamous cell carcinomas (HNSCCs) with residual neck nodes after definitive chemoradiation therapy and compares the Hopkins criteria with anatomic nodal size and morphologic features for prediction of survival outcomes.A total of 72 patients with HNSCC, with negative primary tumor and positive residual neck nodes (CT criteria1 cm short-axis diameter) after the completion of definitive chemoradiation therapy, were included. PET/CT was performed 6-24 weeks after completion of treatment. FDG uptake in residual nodes on PET/CT was interpreted using a structured qualitative 5-point scale (Hopkins criteria). The 5-point scale was dichotomized to negative (scores 1, 2, and 3) or positive (scores 4 and 5) results. Cystic or necrotic nodes were defined as those with central low attenuation with a relatively hyperdense capsule. Kaplan-Meier curve and Cox regression analysis were performed.On the basis of the Hopkins criteria, 10 (13.9%) patients had positive findings and 62 (86.1%) had negative findings for residual nodal disease. According to CT interpretation, 25 patients (34.7%) had residual cervical lymph nodes greater than or equal to 1.5 cm in diameter, and 41 (56.9%) patients had cystic or necrotic nodes. Patients were followed for a median of 27 months after posttherapy PET/CT. There was a statistically significant difference in overall survival (OS) (hazard ratio, 7.06; p0.001) and progression-free survival (PFS) (hazard ratio, 6.18; p0.001) between patients with negative versus positive residual FDG nodal uptake. There was no statistically significant difference in OS and PFS in patients categorized on the basis of nodal size or morphologic features.PET-based structured qualitative therapy assessment (Hopkins criteria) can predict survival outcomes of patients with HNSCC with residual neck nodes after definitive chemoradiotherapy. |
| Databáze: | OpenAIRE |
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