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 Selection of Patients for Planned Neck Dissection

Journal Article · Tue Mar 01 00:00:00 EST 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.11.034· OSTI ID:21491619

Inokuchi, Haruo ^[1]; Kodaira, Takeshi; Tachibana, Hiroyuki ^[1]; Nakamura, Tatsuya ^[2]; Tomita, Natsuo; Nakahara, Rie ^[1]; Takada, Akinori ^[2]; Mizoguchi, Nobutaka ^[1]; Tamaki, Tsuneo ^[3]; Fuwa, Nobukazu ^[2]

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1. Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya (Japan)
2. Department of Radiation Oncology, Southern Tohoku Proton Center, Koriyama (Japan)
3. Department of Radiology, Nagoya PET Imaging Center, Aichi (Japan)

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.

• OSTI ID: 21491619
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 79, Issue 3; Other Information: DOI: 10.1016/j.ijrobp.2009.11.034; PII: S0360-3016(09)03575-5; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
COMBINED THERAPY
FLUORINE 18
FLUORODEOXYGLUCOSE
HEAD
METASTASES
MULTIVARIATE ANALYSIS
NECK
POSITRON COMPUTED TOMOGRAPHY
UPTAKE
ANTIMETABOLITES
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FLUORINE ISOTOPES
HOURS LIVING RADIOISOTOPES
ISOMERIC TRANSITION ISOTOPES
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NANOSECONDS LIVING RADIOISOTOPES
NEOPLASMS
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ODD-ODD NUCLEI
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