The Role of Pretreatment FDG-PET in Nasopharyngeal Carcinoma Treated With Intensity-Modulated Radiotherapy

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• 作者：Wen-Shan Liu ; M.D.^&lowast ; ; Ming-Fang Wu ; M.D.^&dagger ; ; Hsien-Chun Tseng ; M.D.^&lowast ; ; Jung-Tung Liu ; M.D.^&Dagger ; ; Jui-Hung Weng ; M.D.^§ ; ; Yueh-Chun Li ; M.D.^&lowast ; ; Jong-Kang Lee ; M.D.^¶ ; ; ^{jongkanglee@hotmail.com}
• 关键词：18F-FDG-PET ; Nasopharyngeal carcinoma ; Therapeutic outcome
• 刊名：International Journal of Radiation Oncology*Biology*Physics
• 出版年：2012
• 出版时间：1 February 2012
• 年：2012
• 卷：82
• 期：2
• 页码：561-566
• 全文大小：219 K

文摘

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Purpose

Pretreatment with 2- [¹⁸F] fluorodeoxyglucose positron emission tomography (¹⁸F-FDG-PET) was evaluated as a predictor of local failure-free survival (LFFS), disease-free survival (DFS), and overall survival (OS) in patients with nonkeratinizing nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiation therapy (IMRT) alone or concurrently with chemotherapy (CCRT).

Patients and Methods

Seventy-five M0 NPC patients who received FDG-PET before treatment were analyzed. The primary tumor FDG uptake was measured as the maximum standardized uptake value (SUVmax). The LFFS, DFS, and OS were calculated by the Kaplan-Meier method, and the differences were evaluated on log-rank test. The prognostic significance was assessed by univariate and multivariate analyses.

Results

Eighteen patients received IMRT alone and 57 received CCRT. The mean SUVmax was significantly higher in 12 patients with locoregional or distant failure than in those without failure (p <0.001). On multivariate analysis, the SUVmax was the only significant variable for 5-year LFFS (p = 0.017) and DFS (p = 0.000) but not for OS (p = 0.065).

Conclusion

SUVmax is a potential independent prognostic predictor of clinical outcomes in patients with nasopharyngeal carcinoma treated with IMRT alone or with CCRT. A high ¹⁸F-FDG uptake (SUVmax >5) indicates poor outcome in patients with NPC.