Clinical Usefulness of [(18)F] Fluoro-2-Deoxy-d-Glucose Uptake in 178 Head-and-Neck Cancer Patients With Nodal Metastasis Treated With Definitive Chemoradiotherapy: Consideration of Its Prognostic Value and Ability to Provide Guidance for Optimal Selectio

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• 作者：Haruo Inokuchi M.D.^* ; ^{h.inokuchi@scchr.jp} ; Takeshi Kodaira M.D.^* ; Hiroyuki Tachibana M.D.^* ; Tatsuya Nakamura M.D.^† ; ; Natsuo Tomita M.D.^* ; Rie Nakahara M.D.^* ; Akinori Takada M.D.^† ; ; Nobutaka Mizoguchi M.D.^* ; Tsuneo Tamaki M.D.^‡ ; ; Nobukazu Fuwa M.D.^† ;
• 刊名：International Journal of Radiation Oncology*Biology*Physics
• 出版年：2011
• 出版时间：1 March 2011
• 年：2011
• 卷：79
• 期：3
• 页码：747-755
• 全文大小：173 K

文摘

Purpose

To evaluate the clinical effectiveness of pretreatment [(18)F] fluoro-2-deoxy-d-glucose-positron emission tomography for head-and-neck squamous cell carcinoma patients with nodal metastasis treated with chemoradiotherapy.

Methods and Materials

Between March 2002 and December 2006, 178 patients with head-and-neck squamous cell carcinoma and nodal metastasis underwent fluoro-2-deoxy-d-glucose positron emission tomography before chemoradiotherapy. Fluoro-2-deoxy-d-glucose uptake by both the primary lesion and the neck node was measured using the standard uptake value (SUV). The overall survival, disease-free survival, local control, nodal progression-free survival, and distant metastasis-free survival rates were calculated, and several prognostic factors were evaluated.

Results

The patients with a nodal SUV ≥6.00 had a significantly lower 3-year disease-free survival rate than those with a lower SUV (44 % vs. 69 % , p = .004). On multivariate analysis, a high SUV of nodal disease also proved to be a significantly unfavorable factor for disease-free survival (p = .04, 95 % confidence interval [CI], 1.02–3.23), nodal progression-free survival (p = .05; 95 % CI, 1.00–4.15), and distant metastasis-free survival (p = .016; 95 % CI, 1.25–8.92). Among the patients with a greater nodal SUV (≥6.00), those treated with planned neck dissection had better nodal progression-free survival than those in the observation group (p = .04, hazard ratio, 2.36; 95 % CI, 1.00–5.85).

Conclusion

Among head-and-neck squamous cell carcinoma patients treated with chemoradiotherapy, the pretreatment SUV of nodal disease was one of the strongest prognostic factors and also provided important information for the selection of patients suitable for planned neck dissection.