Postradiation Metabolic Tumor Volume Predicts Outcome in Head-and-Neck Cancer

Journal Article · Wed Jun 01 00:00:00 EDT 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2010.01.057· OSTI ID:21491773

Murphy, James D; La, Trang H; Chu, Karen ^[1]; Quon, Andrew ^[2]; Fischbein, Nancy J ^[3]; Maxim, Peter G; Graves, Edward E; Loo, Billy W ^[1]; Le, Quynh-Thu ^[1]

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1. Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA (United States)
2. Department of Nuclear Medicine, Stanford University School of Medicine, Stanford, CA (United States)
3. Department of Radiology, Stanford University School of Medicine, Stanford, CA (United States)

Purpose: To explore the prognostic value of metabolic tumor volume measured on postradiation {sup 18}F-fluorodeoxyglucose positron emission tomography (PET) imaging in patients with head-and-neck cancer. Methods and Materials: Forty-seven patients with head-and-neck cancer who received pretreatment and posttreatment PET/computed tomography (CT) imaging along with definitive chemoradiotherapy were included in this study. The PET/CT parameters evaluated include the maximum standardized uptake value, metabolic tumor volume (MTV{sub 2.0}-MTV{sub 4.0}; where MTV{sub 2.0} refers to the volume above a standardized uptake value threshold of 2.0), and integrated tumor volume. Kaplan-Meier and Cox regression models were used to test for association between PET endpoints and disease-free survival and overall survival. Results: Multiple postradiation PET endpoints correlated significantly with outcome; however, the most robust predictor of disease progression and death was MTV{sub 2.0}. An increase in MTV{sub 2.0} of 21cm{sup 3} (difference between 75th and 25th percentiles) was associated with an increased risk of disease progression (hazard ratio [HR]= 2.5, p = 0.0001) and death (HR = 2.0, p = 0.003). In patients with nonnasopharyngeal carcinoma histology (n = 34), MTV{sub 2.0} <18 cm{sup 3} and MTV{sub 2.0} {>=}18 cm{sup 3} yielded 2-year disease-free survival rates of 100% and 63%, respectively (p = 0.006) and 2-year overall survival rates of 100% and 81%, respectively (p = 0.009). There was no correlation between MTV{sub 2.0} and disease-free survival or overall survival with nasopharyngeal carcinoma histology (n = 13). On multivariate analysis, only postradiation MTV{sub 2.0} was predictive of disease-free survival (HR = 2.47, p = 0.0001) and overall survival (HR = 1.98, p = 0.003). Conclusions: Postradiation metabolic tumor volume is an adverse prognostic factor in head-and-neck cancer. Biomarkers such as MTV are important for risk stratification and will be valuable in the future with risk-adapted therapies.

• OSTI ID: 21491773
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 80, Issue 2; Other Information: DOI: 10.1016/j.ijrobp.2010.01.057; PII: S0360-3016(10)00231-2; 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
NECK
POSITRON COMPUTED TOMOGRAPHY
VOLUME
ANTIMETABOLITES
BETA DECAY RADIOISOTOPES
BETA-PLUS DECAY RADIOISOTOPES
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DIAGNOSTIC TECHNIQUES
DISEASES
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EMISSION COMPUTED TOMOGRAPHY
FLUORINE ISOTOPES
HOURS LIVING RADIOISOTOPES
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
LIGHT NUCLEI
MEDICINE
NANOSECONDS LIVING RADIOISOTOPES
NEOPLASMS
NUCLEI
ODD-ODD NUCLEI
RADIOISOTOPES
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