FDG-PET/CT as prognostic factor and surveillance tool for postoperative radiation recurrence in locally advanced head and neck cancer.
10.3857/roj.2011.29.4.243
- Author:
Giwon KIM
;
Yeon Sil KIM
;
Eun Ji HAN
;
Ie Ryung YOO
;
Jin Ho SONG
;
Sang Nam LEE
;
Jong Hoon LEE
;
Byung Oak CHOI
;
Hong Seok JANG
;
Sei Chul YOON
- Publication Type:Original Article
- Keywords:
Head and neck squamous cell carcinoma;
Metabolic tumor volume;
Positron-emission tomography;
Postoperative radiation therapy;
Locoregional recurrence
- MeSH:
Carcinoma, Squamous Cell;
Chemoradiotherapy;
Disease-Free Survival;
Electrons;
Follow-Up Studies;
Head;
Head and Neck Neoplasms;
Humans;
Neck;
Neck Dissection;
Positron-Emission Tomography;
Radiotherapy, Adjuvant;
Recurrence;
ROC Curve;
Tumor Burden
- From:Radiation Oncology Journal
2011;29(4):243-251
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To evaluate the prognostic value of metabolic tumor volume (MTV) and maximum standardized uptake value (SUVmax) on initial positron emission tomography-computed tomography (PET-CT) and investigate the clinical value of SUVmax for early detection of locoregional recurrent disease after postoperative radiotherapy in patients with locally advanced head and neck squamous cell carcinoma (HNSCC). MATERIALS AND METHODS: A total of 100 patients with locally advanced HNSCC received primary tumor excision and neck dissection followed by adjuvant radiotherapy with or without chemotherapy. The MTV and SUVmax were measured from primary sites and neck nodes. The prognostic value of MTV and SUVmax were assessed using initial staging PET/CT (study A). Follow-up PET/CT scan available after postoperative concurrent chemoradiotherapy or radiotherapy were evaluated for the SUVmax value and correlated with locoregional recurrence (study B). A receiver operating characteristic (ROC) curve analysis was used to define a threshold value of SUVmax with the highest accuracy for recurrent disease assessment. RESULTS: High MTV (>41 mL) is negative prognostic factor for disease free survival (p = 0.041). Postradiation SUVmax was significantly correlated with locoregional recurrence (hazard ratio, 1.812; 95% confidence interval, 1.361 to 2.413; p < 0.001). A cut-off value of 5.38 from follow-up PET/CT was identified as having maximal accuracy for detecting locoregional recurrence by ROC analysis. CONCLUSION: MTV at staging work-up was significantly associated with disease free survival. The SUVmax value from follow-up PET/CT showed high diagnostic accuracy for the detection of locoregional recurrence in postoperatively irradiated HNSCC.
