Can 鈥渆arly鈥?and 鈥渓ate鈥?¹⁸F-FDG PET-CT be used as prognostic factors for the clinical outcome of patients with locally advanced head and neck cancer treated with radio-chemotherapy?

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• 作者：Paola Castaldi^a ; Vittoria Rufini^a ; ^{v.rufini@rm.unicatt.it} ; Francesco Bussu^b ; Francesco Miccichè ; ^c ; Nicola Dinapoli^c ; Rosa Autorino^c ; Mariaelena Lago^a ; Eugenio De Corso^b ; Giovanni Almadori^b ; Jacopo Galli^b ; Gaetano Paludetti^b ; Alessandro Giordano^a ; Vincenzo Valentini^c
• 关键词：18F-FDG PET&ndash ; CT ; Head and neck carcinomas ; Radio-chemotherapy ; Response evaluation
• 刊名：Radiotherapy and Oncology
• 出版年：2012
• 期刊代码：231_01678140
• 类别：med
• 出版时间：April, 2012
• 卷：103
• 期：1
• 页码：63-68
• 文件大小：382 K

摘要

Purpose

To evaluate the prognostic value of 鈥渆arly鈥?and 鈥渓ate鈥?Fluorine-18-Fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography-computed tomography (PET-CT) in patients with head and neck squamous cell carcinoma (HNSCC) treated with radio-chemotherapy (RTCT).

Materials and methods

Twenty-six patients treated with RTCT for HNSCC were included. All patients underwent ¹⁸F-FDG PET-CT at baseline (鈥渟taging鈥?PET-CT), after 2 weeks of treatment (鈥渆arly鈥?PET-CT) and 8-12 weeks after treatment (鈥渓ate鈥?PET-CT). Changes in FDG uptake in the primary tumor (T) and lymph nodes (N) were correlated with local and regional control, respectively; overall metabolic response was correlated with relapse free survival (RFS) and disease specific survival (DSS).

Results

After a median follow-up of 29.2 months, 19/26 patients were living and 17/19 had no evidence of disease. When comparing 鈥渟taging鈥? 鈥渆arly鈥?and 鈥渓ate鈥?PET results, a significant decrease of FDG SUV_max in T and N was documented. When correlating changes in FDG uptake in T and N with local and regional control, a statistically significant correlation only with the 鈥渓ate鈥?reduction was found. Statistical analysis failed to demonstrate any correlation between the 鈥渆arly鈥?metabolic response and the patient clinical outcome while the 鈥渓ate鈥?metabolic response revealed a strong correlation with RFS (p = 0.01) and DSS (p = 0.009).

Conclusions

In patients with HNSCC, PET-CT performed after RTCT predicts the clinical outcome, since it strongly correlates with RFS and DSS. On the other hand, the predictive role of 鈥渆arly鈥?metabolic response was not confirmed by this study.