Validation that Metabolic Tumor Volume Predicts Outcome in Head-and-Neck Cancer

Journal Article · Wed Aug 01 04:00:00 EDT 2012 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2011.10.023· OSTI ID:22149402

Tang, Chad; Murphy, James D.; Khong, Brian; La, Trang H. ^[1]; Kong, Christina ^[2]; Fischbein, Nancy J. ^[3]; Colevas, A. Dimitrios ^[4]; Iagaru, Andrei H. ^[3]; Graves, Edward E.; Loo, Billy W. ^[1]; Le, Quynh-Thu ^[1]

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1. Department of Radiation Oncology, Stanford University, Stanford, CA (United States)
2. Department of Pathology, Stanford University, Stanford, CA (United States)
3. Department of Radiology, Stanford University, Stanford, CA (United States)
4. Division of Medical Oncology, Department of Medicine, Stanford University, Stanford, CA (United States)

Purpose: We have previously reported that metabolic tumor volume (MTV) obtained from pretreatment {sup 18}F-fluorodeoxydeglucose positron emission tomography (FDG PET)/ computed tomography (CT) predicted outcome in patients with head-and-neck cancer (HNC). The purpose of this study was to validate these results on an independent dataset, determine whether the primary tumor or nodal MTV drives this correlation, and explore the interaction with p16{sup INK4a} status as a surrogate marker for human papillomavirus (HPV). Methods and Materials: The validation dataset in this study included 83 patients with squamous cell HNC who had a FDG PET/CT scan before receiving definitive radiotherapy. MTV and maximum standardized uptake value (SUV{sub max}) were calculated for the primary tumor, the involved nodes, and the combination of both. The primary endpoint was to validate that MTV predicted progression-free survival and overall survival. Secondary analyses included determining the prognostic utility of primary tumor vs. nodal MTV. Results: Similarly to our prior findings, an increase in total MTV of 17 cm{sup 3} (difference between the 75th and 25th percentiles) was associated with a 2.1-fold increase in the risk of disease progression (p = 0.0002) and a 2.0-fold increase in the risk of death (p = 0.0048). SUV{sub max} was not associated with either outcome. Primary tumor MTV predicted progression-free (hazard ratio [HR] = 1.94; p < 0.0001) and overall (HR = 1.57; p < 0.0001) survival, whereas nodal MTV did not. In addition, MTV predicted progression-free (HR = 4.23; p < 0.0001) and overall (HR = 3.21; p = 0.0029) survival in patients with p16{sup INK4a}-positive oropharyngeal cancer. Conclusions: This study validates our previous findings that MTV independently predicts outcomes in HNC. MTV should be considered as a potential risk-stratifying biomarker in future studies of HNC.

• OSTI ID: 22149402
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 5 Vol. 83; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BIOLOGICAL MARKERS
CAT SCANNING
DATASETS
DEATH
FLUORINE 18
FLUORODEOXYGLUCOSE
HEAD
HEALTH HAZARDS
NECK
NEOPLASMS
PATIENTS
POSITRON COMPUTED TOMOGRAPHY
RADIOTHERAPY
VALIDATION