Volume 124, Issue 12 pp. 2732-2738

Head and Neck

Interim FDG PET/CT for predicting the outcome in patients with head and neck cancer

Shang-Wen Chen MD,

Shang-Wen Chen MD

Department of Radiation Oncology, China Medical University, Taichung

School of Medicine, China Medical University, Taichung

School of Medicine, Taipei Medical University, Taipei, Taiwan

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Te-Chun Hsieh MD,

Te-Chun Hsieh MD

Department of Nuclear Medicine and PET Center, China Medical University, Taichung

Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung

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Kuo-Yang Yen BSc,

Kuo-Yang Yen BSc

Department of Nuclear Medicine and PET Center, China Medical University, Taichung

Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung

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Shih-Neng Yang MD,

Shih-Neng Yang MD

Department of Radiation Oncology, China Medical University, Taichung

Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung

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Yao-Ching Wang MD,

Yao-Ching Wang MD

Department of Radiation Oncology, China Medical University, Taichung

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Chun-Ru Chien MD, PhD,

Chun-Ru Chien MD, PhD

Department of Radiation Oncology, China Medical University, Taichung

School of Medicine, China Medical University, Taichung

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Ji-An Liang MD,

Ji-An Liang MD

Department of Radiation Oncology, China Medical University, Taichung

School of Medicine, China Medical University, Taichung

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Chia-Hung Kao MD,

Corresponding Author

Chia-Hung Kao MD

Department of Nuclear Medicine and PET Center, China Medical University, Taichung

School of Medicine, China Medical University, Taichung

Send correspondence to Chia-Hung Kao, MD, Department of Nuclear Medicine and PET Center, China Medical University Hospital, No 2. Yur-Der Road, Taichung 404, Taiwan. E-mail: [email protected]Search for more papers by this author

Shang-Wen Chen MD,

Shang-Wen Chen MD

Department of Radiation Oncology, China Medical University, Taichung

School of Medicine, China Medical University, Taichung

School of Medicine, Taipei Medical University, Taipei, Taiwan

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Te-Chun Hsieh MD,

Te-Chun Hsieh MD

Department of Nuclear Medicine and PET Center, China Medical University, Taichung

Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung

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Kuo-Yang Yen BSc,

Kuo-Yang Yen BSc

Department of Nuclear Medicine and PET Center, China Medical University, Taichung

Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung

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Shih-Neng Yang MD,

Shih-Neng Yang MD

Department of Radiation Oncology, China Medical University, Taichung

Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung

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Yao-Ching Wang MD,

Yao-Ching Wang MD

Department of Radiation Oncology, China Medical University, Taichung

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Chun-Ru Chien MD, PhD,

Chun-Ru Chien MD, PhD

Department of Radiation Oncology, China Medical University, Taichung

School of Medicine, China Medical University, Taichung

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Ji-An Liang MD,

Ji-An Liang MD

Department of Radiation Oncology, China Medical University, Taichung

School of Medicine, China Medical University, Taichung

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Chia-Hung Kao MD,

Corresponding Author

Chia-Hung Kao MD

Department of Nuclear Medicine and PET Center, China Medical University, Taichung

School of Medicine, China Medical University, Taichung

First published: 10 July 2014

https://doi.org/10.1002/lary.24826

Citations: 37

Financial Disclosure: Grant support (CMU98-C-13) of China Medical University; and Health and welfare surcharge of tobacco products, China Medical University Hospital Cancer Research Center of Excellence (MOHW103-TD-B-111-03, Taiwan). The authors have no other funding, financial relationships, or conflicts of interest to disclose.

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Abstract

Objectives/Hypothesis

The study aimed to investigate the prognostic effects of interim ¹⁸fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (PET/CT) during definitive radiotherapy (RT) or chemoradiotherapy (CRT) in patients with head and neck cancer.

Study Design

This is a prospectively treatment study.

Methods

The pretreatment and interim PET/CT images of 51 patients with advanced pharyngeal cancers receiving definitive RT/CRT were evaluated prospectively. The interim PET/CT images were taken at a cumulative RT dose ranging from 41.4 to 46.8 Gy. The maximum standardized uptake value (SUVm) of the interim PET/CT and the reduction ratio of the SUVm (SRR) between the two images were measured. The differences between patients with or without local failures were examined using the Mann-Whitney test. Overall survival (OS), disease-free survival (DFS), and primary and nodal relapse-free survival rates were calculated using the Kaplan-Meier method. Independent prognosticators were identified using Cox regression analysis.

Results

After a median follow-up duration of 23 months, a higher interim SUVm was associated with local failures. Conducting a multivariate analysis revealed that a SUVmax reduction ratio of primary tumor (SRR-P) < 0.64 was associated with the inferior OS (hazard ratio 2.64; P =0.035) and DFS (hazard ratio 2.33; P = 0.045). Patients who had tumors with an SRR-P < 0.64 had a considerably lower 2-year OS and DFS compared with those who had SRR-P ≥ 0.64 (47% vs. 66%; 41% vs. 64%).

Conclusion

A higher interim SUVm was associated with local recurrence. In addition, patients with a lower SRR-P should be considered to be at risk of primary failure.

Level of Evidence

4. Laryngoscope, 124:2732–2738, 2014

Supporting Information

BIBLIOGRAPHY

1 Schinagl DA, Span PN, Oyen WJ, Kaanders JH. Can FDG PET predict radiation treatment outcome in head and neck cancer? Results of a prospective study. Eur J Nucl Med Mol Imaging 2011; 38: 1449–1458.
10.1007/s00259-011-1789-x
PubMed Web of Science® Google Scholar
2 La TH, Filion EJ, Turnbull BB, et al. Metabolic tumor volume predicts for recurrence and death in head-and-neck cancer. Int J Radiat Oncol Biol Phys 2009; 74: 1335–1341.
10.1016/j.ijrobp.2008.10.060
PubMed Web of Science® Google Scholar
3 Kao CH, Lin SC, Hsieh TC, et al. Use of pretreatment metabolic tumor volumes to predict the outcome of pharyngeal cancer treated by definitive radiotherapy. European J Nucl Med Mol Imag 2012; 39: 1297–1305.
10.1007/s00259-012-2127-7
PubMed Web of Science® Google Scholar
4 Lim R, Eaton A, Lee NY, et al. 18F-FDG PET/CT metabolic tumor volume and total lesion glycolysis predict outcome in oropharyngeal squamous cell carcinoma. J Nucl Med 2012; 53: 1506–1513.
Web of Science® Google Scholar
5 Moon SH, Choi JY, Lee HJ, et al. Prognostic value of 18F-FDG PET/CT inpatients with squamous cell carcinoma of the tonsil: comparison of volume-based metabolic parameters. Head Neck 2013; 35: 15–22.
10.1002/hed.22904
PubMed Web of Science® Google Scholar
6 Higgins KA, Hoang JK, Roach MC, et al. Analysis of pretreatment FDG-PET SUV parameters in head and neck cancer: tumor SUVMEAN has superior prognostic value. Int J Radiat Oncol Biol Phys 2012; 82: 548–553.
10.1016/j.ijrobp.2010.11.050
PubMed Web of Science® Google Scholar
7 Chung MK, Jeong HS, Park SG, et al. Metabolic tumor volume of [18F]-fluorodeoxyglucose positron emission tomography/computed tomography predicts short-term outcome to radiotherapy with or without chemotherapy in pharyngeal cancer. Clin Cancer Res 2009; 15: 5861–5868.
10.1158/1078-0432.CCR-08-3290
CAS PubMed Web of Science® Google Scholar
8 Aukema TS, Kappers I, Olmos RA, et al. Is 18F-FDG PET/CT useful for the early prediction of histopathologic response to neoadjuvant erlotinib in patients with non-small cell lung cancer? J Nucl Med 2010; 51: 1344–1348.
10.2967/jnumed.110.076224
CAS PubMed Web of Science® Google Scholar
9 Cerci JJ, Pracchia LF, Linardi CC, et al. 18F-FDG PET after 2 cycles of ABVD predicts event-free survival in early and advanced Hodgkin lymphoma. J Nucl Med 2010; 51: 1337–1343.
10.2967/jnumed.109.073197
CAS PubMed Web of Science® Google Scholar
10 Kostakoglu L Goldsmith SJ. PET in the assessment of therapy response in patients with carcinoma of the head and neck and of the esophagus. J Nucl Med 2004; 45: 56–68.
PubMed Web of Science® Google Scholar
11 Berlangieri SU, Brizel DM, Scher RL, et al. Pilot study of positron emission tomography in patients with advanced head and neck cancer receiving radiotherapy and chemotherapy. Head Neck 1994; 16: 340–346.
10.1002/hed.2880160408
CAS PubMed Web of Science® Google Scholar
12 Brun E, Kjellen E, Tennvall J, et al. FDG PET studies during treatment: prediction of therapy outcome in head and neck squamous cell carcinoma. Head Neck 2002; 24: 127–135.
10.1002/hed.10037
CAS PubMed Web of Science® Google Scholar
13 Hentschel M, Appold S, Schreiber A, et al. Early FDG PET at 10 or 20 Gy under chemoradiotherapy is prognostic for locoregional control and overall survival in patients with head and neck cancer. Eur J Nucl Med Mol Imaging2011; 38: 1203–11.
10.1007/s00259-011-1759-3
PubMed Web of Science® Google Scholar
14 Goodman MD, Tarnoff M, Kain M, Slotman GJ. Interactions between outcomes and tumour response to preoperative cisplatin-sensitized radiotherapy in advanced head and neck cancer. Southern New Jersey Head and Neck Cancer Treatment Group. Am J Surg 1997; 174: 527–531.
10.1016/S0002-9610(97)00151-7
CAS PubMed Web of Science® Google Scholar
15 Wanebo H, Chougule P, Ready N, et al. Surgical resection is necessary to maximize tumour control in function-preserving, aggressive chemoradiation protocols for advanced squamous cancer of the head and neck (stage III and IV). Ann Surg Oncol 2001; 8: 644–650.
10.1007/s10434-001-0644-x
CAS PubMed Web of Science® Google Scholar
16 Szabo G, Kreidler J, Hollmann K, et al. Intra-arterial preoperative cytostatic treatment versus preoperative irradiation: a prospective, randomised study of lingual and sublingual carcinomas. Cancer 1999; 86: 1381–1386.
10.1002/(SICI)1097-0142(19991015)86:8<1381::AID-CNCR1>3.0.CO;2-V
CAS PubMed Web of Science® Google Scholar
17 Farrag A, Ceulemans G, Voordeckers M, Everaert H, Storme G. Can 18F-FDG-PET response during radiotherapy be used as a predictive factor for the outcome of head and neck cancer patients? Nucl Med Commun 2010; 31: 495–501.
PubMed Web of Science® Google Scholar
18 Kao CH, Hsieh TC, Yu CY, et al. 18F-FDG PET/CT-based gross tumor volume definition for radiotherapy in head and neck cancer: a correlation study between suitable uptake value threshold and tumor parameters. Radiat Oncol 2010; 5: 76.
10.1186/1748-717X-5-76
PubMed Web of Science® Google Scholar
19 Chen SW, Yang SN, Liang JA, Lin FJ Tsai MH. Prognostic impact of tumor volume in patients with stage III-IVA hypopharyngeal cancer without bulky lymph nodes treated with definitive concurrent chemoradiotherapy. Head Neck 2009; 31: 709–716.
10.1002/hed.21011
CAS PubMed Web of Science® Google Scholar
20 Yang SN, Liao CY, Chen SW, et al. Clinical implications of the tumor volume reduction rate in head-and-neck cancer during definitive intensity-modulated radiotherapy for organ preservation. Int J Radiat Oncol Biol Phys 2011; 79: 1096–1103.
10.1016/j.ijrobp.2009.12.055
PubMed Web of Science® Google Scholar
21 Geets X, Tomsej M, Lee JA, et al. Adaptive biological image-guided IMRT with anatomic and functional imaging in pharyngo-laryngeal tumors: impact on target volume delineation and dose distribution using helical tomotherapy. RadiotherOncol 2007; 85: 105–115.
10.1016/j.radonc.2007.05.010
PubMed Web of Science® Google Scholar
22 Barker JL, Garden AS, Ang KK, et al. Quantification of volumetric and geometric changes occurring during fractionated radiotherapy for head and neck cancer using an integrated CT/linear accelerator system. Int J Radiat Oncol Biol Phys 2004; 59: 960–970.
10.1016/j.ijrobp.2003.12.024
PubMed Web of Science® Google Scholar

Citing Literature

Volume124, Issue12

December 2014

Pages 2732-2738

Filename	Description
lary24826-sup-0001-suppfig1a.tif749.1 KB	Supplementary Information Figure 1a.
lary24826-sup-0002-suppfig1b.tif742 KB	Supplementary Information Figure 1b.
lary24826-sup-0003-suppfig2.tif642.4 KB	Supplementary Information Figure 2.

Interim FDG PET/CT for predicting the outcome in patients with head and neck cancer

Abstract

Objectives/Hypothesis

Study Design

Methods

Results

Conclusion

Level of Evidence

Supporting Information

BIBLIOGRAPHY

Citing Literature

References

Information

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Interim FDG PET/CT for predicting the outcome in patients with head and neck cancer

Abstract

Objectives/Hypothesis

Study Design

Methods

Results

Conclusion

Level of Evidence

Supporting Information

BIBLIOGRAPHY

Citing Literature

References

Related

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