Prognostic Value of Metabolic Tumor Volume and Velocity in Predicting Head and Neck Cancer Outcomes
| Autor: | Daniel T. Chang, James D. Murphy, Edward E. Graves, Andrei Iagaru, A Hsu, Karen P. Chu, Peter G. Maxim, Trevor E. Krakow, Quynh-Thu Le, Billy W. Loo, Trang H. La |
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| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Oncology
Adult Male Cancer Research medicine.medical_specialty Time Factors Multimodal Imaging Article Fluorodeoxyglucose F18 Internal medicine parasitic diseases Biomarkers Tumor Medicine Humans Radiology Nuclear Medicine and imaging Positron emission Karnofsky Performance Status Survival analysis Aged Neoplasm Staging Proportional Hazards Models Aged 80 and over Radiation medicine.diagnostic_test business.industry Proportional hazards model Head and neck cancer Hazard ratio Cancer Middle Aged medicine.disease Primary tumor Survival Analysis Tumor Burden Positron emission tomography Head and Neck Neoplasms Positron-Emission Tomography Disease Progression Female Lymph Nodes Radiopharmaceuticals business Nuclear medicine Tomography X-Ray Computed Follow-Up Studies |
| Popis: | Purpose We previously showed that metabolic tumor volume (MTV) on positron emission tomography—computed tomography (PET-CT) predicts for disease recurrence and death in head-and-neck cancer (HNC). We hypothesized that increases in MTV over time would correlate with tumor growth and biology, and would predict outcome. We sought to examine tumor growth over time in serial pretreatment PET-CT scans. Methods and Materials From 2006 to 2009, 51 patients had two PET-CT scans before receiving HNC treatment. MTV was defined as the tumor volume ≥50% of maximum SUV (SUV max ). MTV was calculated for the primary tumor, nodal disease, and composite (primary tumor + nodes). MTV and SUV velocity were defined as the change in MTV or SUV max over time, respectively. Cox regression analyses were used to examine correlations between SUV, MTV velocity, and outcome (disease progression and overall survival). Results The median follow-up time was 17.5 months. The median time between PET-CT scans was 3 weeks. Unexpectedly, 51% of cases demonstrated a decrease in SUV max (average, −0.1 cc/week) and MTV (average, −0.3 cc/week) over time. Despite the variability in MTV, primary tumor MTV velocity predicted disease progression (hazard ratio 2.94; p = 0.01) and overall survival (hazard ratio 1.85; p = 0.03). Conclusions Primary tumor MTV velocity appears to be a better prognostic indicator of disease progression and survival in comparison to nodal MTV velocity. However, substantial variability was found in PET-CT biomarkers between serial scans. Caution should be used when PET-CT biomarkers are integrated into clinical protocols for HNC. |
| Databáze: | OpenAIRE |
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